Commonly Asked Patient Questions

What is cryosurgery?
Cryotherapy is the freezing and resulting destruction of cancer cells and surrounding tissue. Urologists use it to cure cancer in the prostate gland and the kidney. Prostate cryotherapy is accomplished by placing several small needles through the perineum and creating one single ice ball that can be sculpted to conform with the shape of the cancer lesion. Needle placement is observed by using bi-plane rectal ultrasound in conjunction with computer planning. Argon gas is used to cool the needles and helium gas is used to heat the needles. Advances in technology over the last several years have enabled cryosurgery to become very precise with minimal complications. There are now long-term studies showing as much as a 92% cure rate. The average procedure takes just over an hour and can be repeated in the future if needed. People of any age group can have the surgery and there is no radiation of any sort used. Also, patients who have failed previous radiation treatments can have cryosurgery performed. It is ideal for patients with high grade disease because the ice ball can grow beyond the prostate capsule. Kidney cryotherapy is accomplished by placing needles percutaneously and creating an ice ball that is sculpted to conform with the size and shape of the tumor. Needle placement is visualized using typical laparoscopic surgical access. Ultasound guidance using a laparoscopic ultrasound transducer allows for tumor measurement and verifies placement of the needles.

Is there any pain after prostate cryosurgery?
There is a sense of urgency, some have bladder spasms, but there is no extreme pain from the needles. Also, you will have a catheter in for one to three weeks.

How soon can I go back to work or golf?
During the procedure a urinary catheter is placed and remains. Once your doctor removes the catheter you may resume normal activities, the average is about two weeks.

What are the potential side effects after prostate cryosurgery?
For prostate cryosurgery there is less than a 2% chance of rectal fistula or incontinence. Unless a nerve sparing procedure is performed, the impotence rate is over 90% because both nerve bundles will be frozen.

How does cryosurgery kill cancer cells?
Cryosurgery kills cancer cells in three ways. The first way is for the ice to form within the cell and rupture its membrane. The second way occurs with cells further away from the needles by removing water from the extracellular medium. The cells respond by shrinking and the high salt concentrations damage the cell. The third way is by freezing the blood vessels within the gland and causing a lack of blood flow. This causes cell death within two days.

What happens to the prostate gland after cryosurgery?
Phagocytosis occurs, which is when the body absorbs some of the dead tissue. The prostate shrinks down on itself and becomes smaller. The dead tissue also becomes tougher and leather like. It does no slough off through the urethra. In fact, a urethral warming catheter is used during the operation to warm the urethra and keep it healthy while freezing around it.