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Cryosurgery of the prostate: techniques and pitfalls
1Prostate Center, Department of Urology, Cleveland Clinic Foundation, Ohio, USA.
The Urologic Clinics of North America
|February 1, 1996
Summary
Prostate cryosurgery shows promising early results for local recurrence, with ongoing technique improvements. Further research is needed for survival data and to optimize this cancer treatment method.
Area of Science:
- Urology
- Oncology
- Surgical Innovation
Background:
- Prostate cryosurgery is an emerging treatment modality.
- Preliminary data focus on local recurrence rates, as survival figures are not yet available.
- The technique is rapidly evolving, with current modifications not yet reflected in existing results.
Purpose of the Study:
- To review preliminary data on prostate cryosurgery outcomes.
- To highlight the evolving nature of the cryosurgical technique.
- To encourage rigorous evaluation of cryosurgery despite initial complication rates.
Main Methods:
- Review of preliminary data and literature on prostate cryosurgery.
- Analysis of local recurrence rates for different disease stages.
- Compilation of reported major complication incidences.
Main Results:
- Local recurrence rates at 1 year range from 8% to 33% for localized disease and 16% to 33% for clinical stage C disease.
- A large series reported a 29% positive biopsy rate at 6 months post-treatment for patients with prior radiation failure.
- Major complications include rectourethral fistulas (2-5%), urinary retention (7-15%), stress incontinence (2-7%), and impotence (50-80%).
Conclusions:
- Despite a notable complication profile, preliminary recurrence data offer optimism for prostate cryosurgery.
- The rapid evolution of cryosurgical techniques necessitates ongoing evaluation.
- Standardizing the surgical methodology can expedite the learning curve for practitioners.