Prostate cancer treatment by high intensity focused ultrasound (HIFU)

What is HIFU prostate cancer treatment?

High intensity focused ultrasound (HIFU) is a non-surgical procedure that uses high frequency ultrasound energy to heat and destroy tissue with cancer in the prostate gland, without affecting healthy surrounding tissue. The prostate gland produces part of the semen and is found underneath the bladder. It surrounds the urethra (the tube that carries urine from the bladder out of the body).

The procedure can be done under general anaesthesia. This means you will be asleep during the treatment. However, for some patients, epidural or spinal anaesthesia is preferable. This completely blocks the feeling in your lower body but you stay awake. Your surgeon and anaesthetist will discuss with you which type of anaesthesia is most suitable in your case.

The procedure is sometimes performed as a day-case, but some patients may need to stay overnight in hospital. Your surgeon will explain the benefits and risks of having HIFU prostate treatment and will also discuss the alternatives to the procedure.

About the procedure

Your surgeon will examine your prostate and bladder with a narrow telescope and if necessary enlarge the channel in the prostate to allow urine to flow more easily after HIFU prostate cancer treatment.

You will be placed (or helped) onto your right side on the table and your surgeon will carefully pass a lubricated ultrasound probe into your rectum. The probe will feel uncomfortable, but should not be painful. An image of your prostate will be displayed on a video screen. Your surgeon will use the probe to focus a high-intensity beam of ultrasound on to the prostate tissue with cancer, so that it heats and destroys it. The procedure usually takes about two to four hours to complete.

HIFU can cause scrotal swelling, making it difficult to pass urine. Afterwards, a catheter (a thin tube) is left in place for three to 14 days to help drain urine from your bladder into a bag.

HIFU prostate treatment is generally considered to be safer than open surgery. For most men, the benefits are much greater than any disadvantages of not being treated. However, all medical procedures carry an element of risk.

The main complications specific to HIFU prostate treatment are listed below.

  • Urinary tract infection. The risk of infection is higher for the first few weeks. It’s important you complete your course of antibiotics to reduce the risk of infection.
  • Stress incontinence (when urine leaks because you coughed, sneezed or made a sudden movement).
  • Very rarely, the ureter or bladder can be damaged by the catheter. This can create scar tissue. You may need surgery to repair this.
  • As with all treatments for prostate cancer, you will be infertile after treatment and will have little or no ejaculatory fluid.
  • Erectile dysfunction (impotence). It’s possible you may not be able to get or maintain an erection after treatment.
  • A repeat treatment may be necessary if the cancer tissue is not completely destroyed or you have a recurrence.

The chance of complications depends on the exact type of procedure you are having and other factors such as your general health. Ask your surgeon to explain how any risks apply to you.

Click here for more information about prostate cancer treatment by HIFU

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