Cryosurgery For Prostate Cancer
What you should know
Cryosurgery, also called cryotherapy or cryoablation, is surgery to treat prostate cancer by freezing the prostate cancer cells. The prostate is a male sex gland that helps make semen.
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- Problems may happen during your cryosurgery that may lead to an open prostate surgery. The cold temperature may cause irritation or damage in and around the prostate. Your prostate or other parts of the urinary tract may get injured during surgery. There is also a danger that a blood or nerve supply may be affected. This may cause you to have more problems urinating or having an erection. You may also have swelling, pelvic pain, or a numb feeling down to your legs. Even after cryosurgery, there is a chance that all of the cancers cells may not be killed or that the tumor may come back. You may need to have more cryosurgeries or other procedures.
- You may get a blood clot in your leg or arm. The clot may travel to your heart or brain and cause life-threatening problems, such as a heart attack or stroke.
- Without treatment, your prostate cancer may continue to grow and push on other structures near it. You may develop more bowel, sex, or urinary problems. Your cancer may also spread to other parts of your body. Once cancer spreads, it becomes more difficult to treat, and other serious problems may develop. This may lead to more serious and often life-threatening problems, such as heart, liver, or brain damage.
The week before your surgery:
- Arrange a ride home. Ask a family member or friend to drive you home after your surgery or procedure. Do not drive yourself home.
- Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.
- Practice pelvic floor exercises, and keep doing them even after your surgery. These exercises squeeze your pelvic floor muscles and help them become stronger. Ask your caregiver for more information about pelvic floor exercises.
- You may need to have blood and urine tests, a transrectal ultrasound, cystoscopy, or prostate biopsy. You may also need other tests, such as a bone scan, chest x-ray, or an electrocardiogram (ECG). Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.
- Write down the correct date, time, and location of your surgery.
The night before your surgery:
- Ask caregivers about directions for eating and drinking.
- You may need to take medicines to clean out your bowel before the surgery, such as magnesium citrate.
- You may be given medicine to help you sleep.
The day of your surgery:
- You may be given an enema (liquid medicine put in your rectum) to help clean out your bowel.
- Ask your caregiver before you take any medicine on the day of your surgery. Bring a list of all the medicines you take, or your pill bottles, with you to the hospital. Caregivers will check that your medicines will not interact poorly with the medicine you need for surgery.
- An anesthesiologist will talk to you before your surgery. You may need medicine to keep you asleep or numb an area of your body during surgery. Tell caregivers if you or anyone in your family has had a problem with anesthesia in the past.
- You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.
What will happen:
- A warming catheter (tube) will be placed in your urethra. This will help protect the urethra and rectum from getting frozen by the cold temperature. Caregivers will put an ultrasound probe into your rectum to guide the insertion of the cryoprobes (probes or needles). Small incisions may be made in your perineum if large cryoprobes will be used. The perineum is the area between your penis and rectum. Six to 30 cryoprobes will be placed into the prostate through your perineum. These cryoprobes are connected to a machine and computer that allows your caregiver to control the temperature. Sensors will also be placed to monitor the temperature of the prostate and the structures around it. A cryogen (freezing liquid chemical) will be passed into the cryoprobes until it fills the prostate.
- Once the cryogen is inside the prostate, your caregiver may set the temperature to the freezing point or lower. This forms small ice balls that freeze the cancer cells. Your caregiver will then allow the ice to thaw by replacing the liquid with another chemical called helium. This whole process will damage and kill the prostate cancer cells. He may repeat the freezing and thawing process to make sure all the cancer cells are killed. When the last thawing is completed, a catheter will be put into your bladder to help drain your urine. The cryoprobes will be removed and any incisions that were made will be closed and covered with bandages.
After your surgery:
You will be taken to a room where you can rest until you are fully awake. Caregivers monitor you closely for any problems. Do not get out of bed until your caregiver says it is okay. When caregivers see that you are okay, you may be taken back to your hospital room. The bandages used to cover your stitches keep the area clean and dry to prevent infection. A caregiver may remove the bandages soon after your surgery to check your perineum. The catheter inserted in your bladder may be left there for 1 to 3 weeks to drain your urine. Ask your caregiver for information on how to take care of your catheter.
Contact a caregiver if
- You cannot make it to your appointment on time.
- You have a fever.
- You have questions or concerns about your surgery.
Seek Care Immediately if
- You cannot urinate, or if you have a catheter, no urine is filling the bag.
- You have new symptoms since the last time you saw your caregiver.
- You have pain that does not go away even after you take pain medicine.
- Your symptoms are getting worse.
- Your urine smells bad and becomes red and very cloudy.
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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.