Objectives: This study was performed to define the patient-reported complications following cryoablation therapy for prostate cancer and to compare these results to previously published patient-reported complications for radical prostatectomy and external beam irradiation.
Methods: A questionnaire similar to previously published patient-reported complication studies was sent to the first 290 patients treated by cryoablation therapy at our institution. The questionnaire was returned by 267 patients. 44 patients were excluded from analysis because of prior irradiation, transurethral prostatectorny or cryoablation, resulting in a study group of 223 patients.
Results: Among the 208 patients with good urinary control preoperatively, 9 (4.3%) patients used incontinence pads following cryoablation. Seven of the 8 patients who used one pad daily reported leakage of only a few drops. Impotency, defmed as an inability to obtain erections adequate for vaginal penetration occurred in 85% of men who were potent preoperatively. Urethrorectal fistula occurred in 1 (0.4%) patient. Bladder outlet obstruction caused by due to stricture or sloughed necrotic prostatic tissue required dilatation or transurethral resection in 9% of patients. Scrotal swelling, penile tingling and pelvic pain occurred in 17%, 14% and I I% of patients, respectively; typically these resolved spontaneously within three months.
Conclusions: Patient-reported complications for cryoablation compared favorably to those reported for radical prostatectomy and external beam irradiation. Patient satisfaction was high. 96% of patients reported that they would choose cryosurgery as a treatment option again.