Cryotherapy (cryosurgery) for prostate cancer freezes the prostatic tissue, causing cancer cells to die. As a minimally invasive procedure, cryotherapy for prostate cancer is sometimes used as an alternative to surgical removal of the prostate gland. In the past, cryotherapy for prostate cancer was associated with significantly higher levels of long-term side effects than were other prostate cancer treatments.
Advances in technology have helped to reduce these side effects. Many men, however, still experience long-term sexual dysfunction following cryotherapy for prostate cancer. 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.
Side Effects Of Cryotherapy
As with all treatments for prostate cancer, cryotherapy can cause a number of different side effects. These will affect each man differently and you may not experience all or any of them. After undergoing prostate cancer cryotherapy, some patients may experience the following side effects:
Hematuria (blood in 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. Blood in the urine should only last a few weeks following treatment. However if bleeding lasts for more than just a few weeks or worsens contact your doctor.
Swelling in the genital area: The entry of the needles through the perineum (the skin and muscles between the scrotum and anus) causes both 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 to alleviate swelling.
Erectile dysfunction: Freezing often damages the nerves near the prostate that control erections. Erectile dysfunction is more common after cryotherapy than after radical prostatectomy. Your doctor may prescribe medications such as viagra to help address any issues with sexual function.
Urinary incontinence: This is generally rare in men who have had cryotherapy as their first treatment for prostate cancer, but it is more common in men who have already had radiation therapy.
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 can be chosen.
Urethro-rectal fistula: Although relatively rare (about 1%) a 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 decreases in fistula occurrence.
Other rare side effects of cryotherapy include long-term incontinence and urinary retention. Permanent, severe incontinence is rare at only about 1% and abscess and permanent numbness of the penis are also quite rare. Newer technology has helped to reduce the side effects of treatment. A new urethral warming device has also helped to lower urethral complications, in addition to better spacing of the probes which makes the procedure safer and more effective.