Cryoablation of the prostate has been used since the mid 1990's and has generally been indicated for lower risk PC or patients who are not candidates for surgery, radiation therapy or may have possibly failed radiation therapy. The mechanism that results in cell death revolves around rapid freezing of the prostate tissue using an argon source, creating an "ice ball", followed by a slow warming. This is repeated twice during the procedure, which can be performed with regional anesthesia. The result is cell membrane disruption and cell death. Side effects related to cryosurgery include sexual dysfunction, urethral stricture or narrowing, hematuria, incontinence, swelling to the penis and scrotum and possible fistula (abnormal connection) between the prostate and rectum.
High Intensity Focused Ultrasound (HIFU)
HIFU was approved by the FDA in 2015 for the "ablation of prostate tissue." The delivery is transrectal via a robotically directed probe focused towards the prostate which heats the gland to 80 degrees Celsius. HIFU works by destroying tissue with rapid heat pulses that focus on the cancer that has not yet spread to other parts of the body. There is constant ultrasound monitoring of the prostate and average treatment varies by the size of the gland but can range from 1 -- 4 hours. Side effects include urethral stricture/narrowing, sexual dysfunction, incontinence and possible injury to the rectal wall.