Acute renal failure with thrombocytopenia after cryosurgery of the prostate

We report three cases of transient acute renal failure accompanied by thrombocytopenia all occurring within 48 h of percutaneous transperineal cryoprostatectomy. Renal function spontaneously improved in all three patients, who currently have normal renal function and are voiding without difficulty. No known risk factor or specific etiology for the renal failure could be identified; therefore, we conclude that the renal failure is most likely secondary to the cryosurgery procedure, a common link shared by all three patients. We are currently administering intravenous mannitol before initiation of the freeze and have seen no further episodes of postcryosurgical acute renal failure in > 50 patients with prostate cancer. Because cryosurgery is currently becoming a more pervasive treatment option for localized prostate cancer, we believe it most important to report this heretofore unrecognized potential complication.