Prostatic cryotherapy. Current experiences

Peter J. Littrup, Ronald A. Sparschu, David Grignon

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Background. Cryotherapy of the prostate has been reintroduced clinically due to improved ultrasound guidance and cryotechnology. Recent data have emerged from the authors' canine histopathology study that corresponds with other encouraging reports from human studies. Methods. Six mongrel dogs received cryotherapy to the entire prostate and were observed for selected periods of 1 day to 12 weeks with transrectal ultrasound (TRUS) follow‐up. Some technical limitations of the canine model prohibited complete comparison with more extensive techniques in humans. Results. TRUS monitoring of posterior ice‐ball progression proved to be highly accurate and correlated with subtotal necrosis of the rectal wall sparing the mucosal layer with millimeter accuracy. Scattered residual glands remained at the distal apex in one dog and in the posterolateral periphery of a larger volume prostate. Without adequate urethral warming, central sloughing was noted in longer term animals. Histology demonstrated hemorrhagic infarction with subsequent ingrowth of transitional epithelium from the urethra, producing reepithelialization of glandular spaces along the residual collagenous architecture. Conclusions. Accurate TRUS monitoring of prostate cryotherapy allows thorough yet careful extension of the ice ball through the posterior aspect of the prostate. Unique histologic changes may account for unremarkable TRUS appearance after cryotherapy as well as some of the benign, “atypical,” glands seen on follow‐up biopsies in humans. These findings may explain the remarkably low residual cancer in humans and encourages further studies on this low morbidity, lower cost definitive therapy. Cancer 1995;75:1957‐62.

Original languageEnglish (US)
Pages (from-to)1957-1962
Number of pages6
JournalCancer
Volume75
Issue number7 S
DOIs
StatePublished - Apr 1 1995

Keywords

  • cancer
  • cryosurgery
  • cryotherapy
  • prostate
  • ultrasound

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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