Functional outcomes after prostatic cryosurgery

Area of Science:

• Urology
• Oncology
• Surgical Innovation

Background:

• Prostate cancer treatment often involves interventions that can affect urinary function.
• Cryosurgery (CS) is a minimally invasive option for prostate cancer, but its impact on micturition requires evaluation.
• Understanding the functional outcomes of CS is crucial for patient counseling and treatment selection.

Purpose of the Study:

• To evaluate the functional effects of prostatic cryosurgery (CS) on male lower urinary tract symptoms (LUTS) and quality of life (QoL).
• To assess changes in voiding parameters, including uroflowmetry and post-void residual (PVR) volume, following CS.
• To determine if medical treatment for LUTS is affected by CS.

Main Methods:

• A prospective study involving 25 men undergoing CS for prostate cancer between 2013-2015.
• Assessment of LUTS and QoL using the International Prostate Symptom Score (IPSS) questionnaire and a 3-day voiding diary (3DVD).
• Uroflowmetry and ultrasound-measured PVR were performed pre-surgery and at 3, 6, and 12 months post-surgery.

Main Results:

• No statistically significant differences were observed in IPSS, QoL, 3DVD, uroflowmetry, or PVR at 3, 6, or 12 months compared to pre-surgery baseline.
• The need for medical treatment for LUTS decreased from 32% pre-CS to 9.5% at 12 months post-CS.
• Nineteen procedures (76%) were primary, and 6 (24%) were salvage CS.

Conclusions:

• Prostatic cryosurgery (CS) does not lead to a worsening of LUTS or a decline in QoL as measured by IPSS, QoL questionnaires, and 3DVD.
• CS appears to have a neutral impact on uroflowmetry parameters.
• The findings suggest CS is functionally safe regarding micturition in the short to medium term.