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Cryoablation (also called cryotherapy or cryosurgery) is a process that freezes cancerous cells in the prostate and cuts off their blood supply. The procedure involves cycles (usually two) of freezing and thawing of the prostate with cooling and warming agents passed through tiny probes into the prostate. Each cryoprobe is a small needle that forms an “ice ball” around the probe, which immediately destroys all of the tissue within the ice (including the cancer).
(But don’t worry about those ice balls. Fortunately, the ice stays local within the prostate and does not affect the family jewels!)
After treatment, your immune system clears out the frozen cells and leaves scar tissue behind.
Cryoablation is less invasive than other prostate procedures, but full-prostate ablation has a high risk of erectile dysfunction. In some cases, Dr. B-T will recommend a focal (partial) ablation. Focal ablation treats only the tumor cells and leaves the rest of the prostate tissue intact. Think of the needle probes as little snipers taking aim at the cancerous cells on your prostate.
When focal cryoablation is possible, you are more likely to retain your sexual and urinary function.
You may be. Dr. B-T will sit down with you and explain your options in detail.
Patients that could benefit from choosing prostate cryoablation include:
As usual when it comes to prostate treatment, size matters. Because the ice can only travel so far, the best-sized prostates are those that are the size of a clementine or smaller. Dr. Rich Bevan-Thomas will always determine the size of your prostate either with an MRI or with an ultrasound in the office. Sometimes, it is possible to shrink the prostate down with medication to get it to the optimal size for cryoablation.
The procedure is usually done as an outpatient with general anesthesia. Most patients go home the same day with a suprapubic tube. (This is a tube that goes through the lower abdomen directly into the bladder.) Dr. Rich Bevan-Thomas will discuss this with you beforehand. Expect your ablation to take one to two hours.
The prostate will swell after the procedure, and it takes a few days for this to resolve. Normally, patients are taught how to plug the tube in about five days so they can try to urinate through the urine channel again. If the voiding trial is successful, the patient comes to the office and the suprapubic tube is removed. (This is not a painful process because we are removing this from the belly and not the penis and urine channel.)
Cryoablation is less invasive than other options, such as robotic prostatectomy. You can expect to have less bleeding, a shorter hospital stay, less pain, and a faster recovery. Cryoablation can also be repeated if you need it down the road.
As with any medical procedure, there are risks to cryoablation. The most common include: