Active hydrodissection might optimize cryosurgical ablation of the prostate.

OBJECTIVE

To produce lower temperatures safely in the prostate, and better protect the rectum , as well as maximize the technique of cryosurgical ablation to better eradicate prostate cancer.

METHODS

A total of 10 consecutive patients underwent total, subtotal, or focal cryosurgical ablation, with saline hydrodissection. We found lethal prostate temperatures and safer rectal temperatures. One patient developed a very small rectourethral fistula that healed with catheter drainage alone, prompting a revised technique. The prostate-specific antigen values at short follow-up were very low.

RESULTS

Temperatures of -10°C to -76°C were achieved outside the prostate at the neurovascular bundle. Post-operative prostate-specific antigen values were 0.10 to 3.4 if total or focal therapy, respectively, was used. A small rectal fistula healed with catheter drainage alone.

CONCLUSIONS

This technique appears to hold great promise and should be investigated further in a larger group of patients with longer follow-up.