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Definition |
Urinary retention appears to be one of the most common side-effects of HIFU, developing in almost allpatients, with the mean interval of catheterization via a suprapubic tube varying between 12 and 35 days. Grade I and II urinary stress incontinence occurs in about 12% of patients. Subsequent TURP or bladder neck incision to treat subvesical obstruction is common, and is sometimes even performed at the time of HIFU. Post-operative impotence occurs in 55-70% of patients.Elterman et al. have treated 95 patients with clinically organ-confined PCa using the Sonablate 500 device(SonaCare Medical, Charlotte, NC, USA) and have evaluated the type and frequency of treatment-associated complications. With a minimum follow-up of six months, 17% (7/41) of the men had significant incontinence,and 2%developed significant erectile dysfunction. Early and late subvesical obstruction necessitating surgical treatment occurred in 17 (17.9%) and 20 (21.1%) patients, respectively.Moderate to severe stress urinary incontinence was rare, occurring in fewer than 6.4% of men, and decreased in more recent treatment to 3.1% . Acute urinary retention was seen in 7.6% of men. Even in more recent treatment, the rate of urethral-rectal fistula was 0.7%.
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