Post-Treatment

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). Peer reviewed journal articles now support the use of these oral medications after treatment to enhance healing. Fortunately, many patients regain potency 6 to 12 months after treatment.

Do I Need Further Tests?

A quarterly measurement of the PSA is recommended for the first two years, and biannual tests are recommended in years three and four. Thereafter we recommend an annual PSA test. 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. If the PSA reading does not return to very low levels, a repeat ultrasound and biopsy can be performed. If this biopsy shows residual tumor (approximately 3% of Canadian cases), a second Ablatherm® HIFU session can be conducted. A major advantage of Ablatherm ® HIFU is that it is repeatable and does not preclude future treatment by any other treatment options. A bone scan and Cat Scan would also be ordered. If biopsies are negative but the PSA rises, additional therapy may be prescribed.

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