High intensity focused ultrasound (HIFU) is a non-surgical procedure to treat prostate cancer which has not spread outside the prostate gland. It works by using high frequency ultrasound energy to heat and destroy cancer tissue in the prostate gland without affecting the surrounding healthy tissue.
The procedure can be done under general anaesthetic; however some patients prefer an epidural which numbs the lower half of the body whilst the patient remains awake. The surgeon and anaesthetist will discuss the most suitable anaesthetic for the patient. The procedure is usually performed as a day-case, although some patients may need to stay in hospital overnight.
During the procedure the surgeon will examine the prostate and bladder with a narrow telescope by inserting a lubricated ultrasound probe into the rectum; this may be uncomfortable but should not be painful. This will display an image of the prostate onto a video screen which will help the surgeon to focus a high intensity beam of ultrasound onto the cancerous tissue to heat and destroy it. This procedure usually takes two to four hours.
HIFU is generally considered to be safer than open surgery, and for most men the benefits outweigh the disadvantages of not being treated. HIFU can cause scrotal swelling, making it difficult to pass urine, so a catheter, a thin tube, is usually left in place for three for fourteen days to help drain away urine from the bladder into a bag.
The long-term side-effects some men may experience after HIFU include urinary problems and erectile dysfunction. Possible short-term side effects include temporary swelling, a urinary tract infection and blood in the urine. The chance of complications depends on the exact type of procedure you are having and other factors such as your general health. The consultant will discuss this in detail with the patient.