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Prostate cancer cryotherapy (cryosurgery)
freezes the entire prostate gland through a minimally
invasive procedure involving ultrathin cryoneedles.
Side effects usually occur due to damage of the surrounding
tissue during the procedure. The severity and occurrence
of side effects are largely affected by the relative
health of a patient as well as whether cryosurgery is
a primary or salvage treatment option. The advent of
the minimally-invasive ultrathin cryoneedles and more
precise imaging techniques has greatly decreased the
occurrence of many side effects, with the exception
of impotence.
After undergoing prostate cancer
cryotherapy, some patients may experience the following
side effects:
Swelling in the Genital
Area after Cryosurgery
The entry of the needles through perineum (the skin
and muscles between the scrotum and anus) causes irritation
and inflammation. Many physicians will recommend using
ice packs on the affected area or beginning a regimen
of over-the-counter anti-inflammatory drug.
Scrotal Edema
A more severe complication, scrotal edema occurs when
fluid collects in the scrotum. Proper evaluation must
be performed by a doctor so that proper course of treatment
may be chosen.
Irritation during Urination
Many men will experience itching or burning while urinating
after undergoing prostate cryosurgery. Symptoms usually
will dissipate in a few days. Some men will also experience
urgency. Speak with your physician if symptoms worsen
after a few days.
Hematuria: Blood in the
Urine
Many men will experience blood in the urine (hematuria)
after undergoing prostate cryotherapy. There are two
types of hematuria, gross and microscopic. Gross hematuria
is visible to the naked eye. If bleeding persists past
a few days, please speak with your physician.
Urethral Sloughing and Urinary
Obstruction
The passage of dead tissue through the urethra, urethral
sloughing, occurs when the urethra is damaged during
the cryotherapy. Fortunately, the use of a warming catheter
has greatly decreased the occurrence of urethral sloughing.
Severe cases of sloughing cause urinary obstruction
and require medical treatment. Men who have undergone
transurethral resection of the prostate (TURP)
or another prostate cancer treatment, such as external
radiation therapy, are at higher risk for urethral sloughing.
Urethro-Rectal Fistula
One of the more serious and rarer side effects is urethro-rectal
fistula. Urethro-rectal fistula occurs when an unnatural
channel forms between the urethra, which carries urine
or ejaculate out of the body, and the rectum, which
holds fecal matter prior to defecation. This channel
allows materials from one part of the body to pass into
another. The results can include diarrhea or urinary
tract infections. New techniques in prostate cryosurgery
have lead to decrease in fistula. The warming catheter
and the ultrathin, precise cryoneedles have contributed
to the decrease of the occurrence of fistula.
Other Side Effects
Other side effects include impotence
and incontinence.
Prostate cryotherapy entails relatively low rates of
incontinence after the catheter is removed. To read
more about incontinence, please click here. Cryotherapy
is associated with higher rates of impotence, which
is the ability of maintain an erection satisfactory
for sexual intercourse. To read more about impotence,
please click here.
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