Will I be Incontinent?
In the first patients treated with Ablatherm® HIFU approximately 1 in 12 experienced either Type 1 or Type 2 incontinence. Type 1 incontinence is the leakage of urine with marked straining. Type 2 is the leakage of urine with mild to moderate straining. Both types of incontinence are manageable with medications and pelvic floor exercises and, if present, last only one month on average. Fortunately, in almost all cases these types of incontinence are temporary. Recent advancements in Ablatherm® HIFU have resulted in even fewer cases of initial Type 1 and Type 2 incontinence. Importantly, there are essentially no total, severe incontinence cases (Type 3) reported unless patients have had previous radiation or surgery.
Will I be Impotent?
Forty percent of patients retain normal erectile function after treatment. This compares favorably with patients undergoing radical surgery. In those patients specifically treated with nerve sparing techniques, erectile function is retained in over 80% of cases. In addition, the majority of patients who suffer erectile dysfunction following treatment by Ablatherm® HIFU will respond to oral medications (Viagra, Levitra, Cialis). Fortunately, many patients regain potency 6 to 12 months after treatment.
Do I Need Further Tests?
A regular measurement of the PSA is recommended every three months. Three to six months after the treatment the PSA should be reduced to almost undetectable levels. If the PSA level is undetectable, no prostate biopsy is necessary in the first 12 months. After 12 months, a biopsy is performed to confirm that the treatment has been successful. After the first year, if the biopsy is negative and PSA level is very low, the PSA only needs to be performed every 6 months.
If the PSA reading does not return to very low levels, a repeat biopsy can be performed. If this biopsy shows residual tumor (approximately 10% of the cases), a second Ablatherm® HIFU session is conducted. If biopsies are negative but the PSA rises, additional therapy may be prescribed.