[Complications of cryosurgery in the treatment of prostatic tumors]

Most of the complications in cryosurgery (pyelonephritis, peritonitis, perforations and haemorrhages) are caused by an indequate control of the freezing process or by the use of unsuitable cryosurgical techniques. To this effect, an important role is played by the unsuitable choice of the kind of freezing probe and the use of an unsuitable freezing time. Only endoscopic cryosurgery enables a precise and exact control by means of viewing through the endoscopic trocar along with simultaneous rectal feeling, both of which enable us to achieve an exact supervision of the size of the subvesically-formed freezing sphere adjacent to the rectum. Short, repeated freezings prevent the risk of necrosis (called "sloughts" by English authors). There is a 2% mortality, bearing in mind that the casuistry in cryosurgery is similar to the normal one in open prostate surgery with the difference in favour of the former that these patients generally belong to the so-called inoperable group or with a special surgical risk and aged between 70 and 80 years old. On the other hand, in both groups of our casuistry, the U.T.R. produced a mortality of only 0.3%.