Voiding Dysfunction, Incontinence, and Erectile Dysfunction Following High-Intensity Focus Ultrasound and Focal Cryotherapy in Treatment of Prostate Cancer
© 2017, Springer Science+Business Media, LLC. Purpose of Review: Prostate cancer is one of the most prevalent malignancies in males and treatment is not infrequently associated with substantial morbidity. As a result, there has been growing interest in alternative therapies for prostate cancer therapy including high-intensity focused ultrasound (HIFU) and focal cryoablation. Herein, we review the potential genitourinary sequelae of these therapies including incontinence and erectile dysfunction. Recent Findings: Various studies have demonstrated that with improvements in delivery technique and technologies aimed at treatment of prostate cancer, the risks of urinary incontinence, urethral obstruction, and erectile dysfunction have decreased. Large studies demonstrate rates of continence in 84–100% of patients and potency in 44–77% of patients treated with HIFU. Focal cryoablation incontinence rates can be as low as 1.6% and erectile function may be preserved in 68.8% of patients. Summary: Urinary incontinence and erectile dysfunction rates are lower in patients treated with HIFU or focal cryoablation compared to patients treated with traditional therapies. However, HIFU patients may experience higher rates of urethral stricture and bladder neck obstruction compared to traditional therapies.
Chang, D; Madden-Fuentes, RJ; Peterson, AC
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