PURPOSE: High Intensity Focused Ultrasound (HIFU) may have a role as a treatment option to standard radical therapies for localized prostate cancer. One attribute of HIFU treatment is that it can be repeated. We aimed to determine the morbidity following primary HIFU and redo-HIFU.
MATERIALS AND METHODS: An academic-lead UK HIFU registry analysis of HIFU treatments across three centres using patient-reported continence and sexual function outcomes. Validated questionnaires were completed before and after each HIFU treatment.
RESULTS: From October 2004 to June 2012 a total of 359 patients were treated with one whole-gland HIFU for localized prostate cancer; 130 (36.2%) had redo-HIFU. Median follow-up was 27 months (range 3-81) after redo-HIFU. When analysing adverse events, 10.8% experienced urinary tract infection after first HIFU compared to 3.9% after redo-HIFU (p=0.009). Urethral dilatation was required in 13.8% and 14.0% after first and after redo-HIFU, respectively (p=0.7). Bladder neck incision was required in 9.2% and 11.6% after first and after redo-HIFU, respectively (p=0.2). Before and after redo-HIFU 73.3 % and 55.1 % respectively, had no leak (p<0.001). Before and after redo-HIFU 2.7 % and 9.0 %, used daily pads (p=0.07). Analysis of erectile function showed that 56.2% and 56.0% (p=0.9) were potent before and after redo-HIFU, respectively.
CONCLUSION: Redo-HIFU is associated with an increase in urinary side-effects but sexual side-effects do not appear to be significantly increased. The number of adverse events seems to be equivalent after first and redo HIFU. Meticulous patient selection is of paramount importance in selecting patients for redo-HIFU.
Written by:
V B1, L D2, N M3, Rg H4, Lm D5, M E2, Hu A2 Are you the author?
1Oslo University Hospital, Norway. Electronic address: . 2Division of Surgery and Interventional Science, UCL; Department of Urology, University College Hospitals NHS Foundation Trust. 3Department of Urology, University College Hospitals NHS Foundation Trust. 4Department of Urology, North Hampshire and Basingstoke Hospital, Hampshire Hospitals NHS Foundation Trust. 5Oslo University Hospital, Norway.
Reference: J Urol. 2013 Dec 24 (Epub ahead of print)
doi: 10.1016/j.juro.2013.12.036
PubMed Abstract
PMID: 24373800
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