Cancer UrologyCancer UrologyОнкоурология1726-97761996-1812Publishing House ABV Press6210.17650/1726-9776-2014-10-2-62-66PROSTATE CANCERРАК ПРЕДСТАТЕЛЬНОЙ ЖЕЛЕЗЫPREVENTION OF DYSURIA AFTER HIFU THERAPY FOR PROSTATE CANCERПРОФИЛАКТИКА РАССТРОЙСТВ МОЧЕИСПУСКАНИЯ ПОСЛЕ HIFU-ТЕРАПИИ РАКА ПРЕДСТАТЕЛЬНОЙ ЖЕЛЕЗЫShestaevA. Yu.ШестаевА. Ю.
Russian Federation
vkardinalova@mail.ruProtoshchakV. V.ПротощакВ. В.
Russian Federation
vkardinalova@mail.ruSinelnikovL. M.СинельниковЛ. М.
Russian Federation
vkardinalova@mail.ruKardinalovaV. A.КардиналоваВ. А.
Russian Federation
vkardinalova@mail.ruYeloevR. A.ЕлоевР. А.
Russian Federation
vkardinalova@mail.ruClinic of Urology, S.M. Kirov Military Medical Academy, Ministry of Defense of Russia, Saint PetersburgКлиника урологии ФГБВОУ ВПО «ВМА им. С.М. Кирова» Минобороны РоссииCity Hospital Forty, Saint PetersburgГБ № 40, Санкт-Петербур3006201410262662507201425072014https://oncourology.abvpress.ru/oncur/article/view/62

Objective: to identify factors for the development of dysuria and its prevention in patients with prostate cancer (PC) after high-intensity focused ultrasound (HIFU) therapy.

Subjects and methods. In September 2008 to June 2013, the Clinic of Urology, S.M. Kirov Military Medical Academy, treated 98 patients, by performing HIFU sessions on an Ablatherm apparatus (EDAP, France). All the patients underwent transurethral resection of the prostate (TURP) to reduce the volume of the ablated tissue. The patients were divided into 2 groups: 1) 29 patients underwent TURP 3 days before HIFU therapy; 2) 69 did this 1 month before major surgery. Each group was divided into 2 subgroups: 1) after ultrasound ablation, a urethral catheter was inserted for 10 days; 2) epicystostoma was applied, followed by its overlapping on day 3 postablation and spontaneous urination. The postoperative incidence of dysuria was estimated from subjective (complaints, voiding diary, and Inter-national Prostate Symptom Score) and objective (uroflowmetry, small pelvic ultrasonography with determination of residual urine volume) criteria.

Results. In the patients who had undergone TURP one month before HIFU therapy, grades I–II urinary incontinence and urethral pros-tatic stricture occurred much less infrequently than in those who had undergone this maneuver 3 days prior to major surgery. Urinary in-continence and urethral prostatic stricture occurred 2-fold more frequently after TURP being carried out 3 days before HIFU therapy than after the urethral catheter being inserted. TURP performed one month before HIFU therapy showed no great difference in the incidence complications regardless of the type of bladder drainage.

Conclusion. The short interval between TURP and HIFU therapy for PC increases the risk of postoperative dysuric events. The optimal time to perform TURP prior to HIFU therapy is 1 month.

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