Active Hydrodissection Might Optimize Cryosurgical Ablation of the Prostate

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