Patient-reported complications after cryoablation therapy for prostate cancer

Objectives. To define the patient-reported complications after cryoablation therapy for prostate cancer and to compare these results to previously pub lished patient-reported complications for radical prostatectomy and externa l beam irradiation. Methods. A questionnaire similar to previously published patient-reported c omplication studies was sent to the first 290 patients treated by cryoablat ion therapy at our institution. The questionnaire was returned by 267 patie nts. Forty-four patients were excluded from analysis because of prior irrad iation, transurethral prostatectomy, or cryoablation, resulting in a study group of 223 patients. Results. Of the 208 patients with good urinary control preoperatively, 9 (4 .3%) patients used incontinence pads after cryoablation. Seven of the 8 pat ients who used one pad daily reported leakage of only a few drops. Impotenc y, defined as an inability to obtain erections adequate for vaginal penetra tion, occurred in 85% of men who were potent preoperatively. Urethrorectal fistula occurred in 1 patient (0.4%). Bladder outlet obstruction caused by stricture or sloughed necrotic prostatic tissue required dilation or transu rethral resection in 10% of patients. Scrotal swelling, penile tingling, an d pelvic pain occurred in 18%, 15%, and 12% of patients, respectively; typi cally, these resolved spontaneously within 3 months. Conclusions, Patient-reported complications for cryoablation compared favor ably to those reported for radical prostatectomy and external beam irradiat ion. Patient satisfaction was high; 96% of patients reported that they woul d choose cryosurgery as a treatment option again. (C) 1999, Elsevier Scienc e Inc.