Cryotherapy is a way of killing cancer cells by freezing them. It is also called cryoablation or cryosurgery. Cryotherapy is usually used to treat prostate cancer that has returned after an initial treatment such as radiotherapy and is termed a salvage treatment. It can be used to treat early localised prostate cancer but it is not known whether it is as effective as surgery or radiotherapy to treat early disease.
This treatment will be performed under an anaesthetic and usually takes between 1 to 2 hours to be performed.
Before the treatment men may have an enema to clear out the lower bowel. This will help the accuracy of treatment and will also reduce the possible risk of infection.
In the treatment room a urinary catheter (see surgery) is placed into the urethra and warm water is flushed through to protect the urethra from becoming damaged during treatment. Cryotherapy needles called cryoprobes are then pushed through the skin of the perineum (the area between the scrotum and the anus) and an ultrasound scan or an X-ray is used to check that they are in the right place. A substance called argon is then circulated through the needles to freeze the prostate cancer and later removed.
Following treatment recovery will take a few hours.
After the treatment
- Men will have a urinary catheter in which will need to stay in place for a few weeks
- The perineal area will be sore and men will need to take painkillers on a regular basis.
- Men will need to avoid strenuous activity for a few weeks while your body heals.
- Men may have some blood in the urine for several weeks after the treatment.
- Very rarely, damage can occur to the back passage (fistula) which may require further surgery.
- A small number of men may develop an infection after cryotherapy and may need to take antibiotics.
Catheters and Catheter care
A catheter is a plastic tube that drains urine from the bladder. It will be connected to a drainage bag. The catheter is held inside the bladder by a balloon that is inflated with sterile water following insertion. It will therefore not usually come out unless properly removed by deflating the balloon. The balloon of the catheter tends to rest over a sensitive area of nerves in the bladder which may become irritated by its presence. This irritation may make a man feel as if he is bursting to pass urine and sometimes the nerves in the bladder will react to this irritation and force a small amount of urine to be expelled from around the catheter.
- Unless instructed otherwise men can have a shower or bath with the catheter in place.
- Do not use powders or lotions around the catheter or penis entry site.
- If men find the catheter is leaking they should not put non sterile materials around the penis.
- It is very important to drink 2 – 3 litres of fluid daily to flush the urine through and water based drinks tend to prevent bacteria forming in the urine which can lead to infection.
- When emptying or connecting catheter bags men should always wash their hands thoroughly with soap and water before and after the procedure.
- Do not pull or tug at the catheter.
Possible long term side effects
There can be a higher risk of erection problems (erectile dysfunction) after HIFU when it is used as salvage treatment in this way due to the effects of previous prostate cancer treatment.For information on managing erection problems please click here Risk of these problems appear to be comparable with other types of treatment such as radiotherapy and surgery when it is used as an initial or focal treatment to treat an area of the prostate rather than the whole gland. This type of treatment is only available at a few specialist centres within the UK and is not a standard treatment for early prostate cancer. It may be a treatment offered as part of a clinical trial.
For information on managing erection problems please click here
Following cryosurgery men will be reviewed in clinic with a PSA blood test on a regular basis.
Last reviewed April 2021. Next review 2022.
References available on request.