Cryosurgery for Prostate Cancer—Experience with Third-Generation Cryosurgery and Novel Developments in the Field

Objectives: To analyse and present the data of our cryosurgery experience for the treatment of prostate cancer. Methods: Between August 2003 and November 2006, a total of 91 patients were treated with cryosurgery for prostate cancer as either primary treatment (n = 49) or salvage treatment (n = 42). The mean follow-up was 19.16 mo (range: 6 wk to 6 mo). Data were collected prospectively. Results: The prostate-specific antigen (PSA) level dropped to <0.5 ng/ml in 67% of all primary treatments and in 59% of all salvage treatments at the first 6-wk postoperative evaluation. At 1 yr, a PSA level below 0.5 ng/ml was found in 59% of primary treatments and 61% of salvage treatments. Three rectourethral fistulas were found (all in the salvage group). Twenty-seven percent (9 of 33) of patients were sexually potent in the primary group and 4.37% (1 of 23) in the salvage group. Conclusions: Our data show that prostate cryosurgery is a safe and effective treatment option in the management of prostate cancer. The complication rate in the salvage group was higher than in the primary group. With the advent of newer temperature-monitoring systems, we envisage that the serious complication of rectourethral fistulas would reduce even further. # 2007 European Association of Urology. Published by Elsevier B.V. All rights reserved.