Normal eating and drinking is generally possible the evening of the treatment day, and the urinary catheter is removed 3 or 4 days after the session. The patient is usually discharged from hospital the day after treatment.
Antibiotics and alpha-blockers to decrease symptoms of prostatic swelling may be prescribed for the following 8 weeks to prevent urinary infection. PSA level measurements and the urinalysis are performed regularly.
If a urinary infection occurs further antibiotics may be required.
During this period, there may be some discomfort: mild bleeding at the start of urination, frequent and sometimes urgent urination, urine leakage during physical exertion or coughing (uncommon), and sometimes the passing of some necrotic debris.
Long term follow-up
A regular PSA check every 3 months for the first year is normal, 6 monthly for the following year and then annually.
A European multi-center study was completed on 402 patients with localized prostate cancer. The results of this study show that after a HIFU treatment, more than 8 patients out of 10 have negative biopsies (87.2%) and a normal PSA level (81.4%).
These results are based on a mean follow-up at 13 months. A study carried out in Lyon, France, with more than 5 years follow-up confirm these results.
Reference: C. Chaussy, S. Thüroff, G. Vallancien, W. Wieland, H.J. Kiel, A. Le Duc, F. Desgranchamps, J. de la Rosette, A. Gelet - High-Intensity Focused Ultrasound and Localized Prostate Cancer: Efficacy Results from the European Multicentric Study - The Journal of Urology, May 2001, Vol.165, 5:388.
Reference: A. Blana, B. Walter, S. Rogenhofer, W.F. Wieland - High-Intensity Focused Ultrasound for the Treatment of Localized Prostate Cancer: 5-year Experience - Urology 63 (2), p. 297-300, 2004
Patients with local recurrence after external radiotherapy
HIFU treatment can be used in patients with local recurrence after external radiotherapy.
The treatment procedure is the same as for first-line therapy but with reduced power. The HIFU equipment has a designated setting specifically for this use.
Sometimes however (5% of cases) the treatment cannot be performed because of abnormal thickening of the rectal wall caused by the radiotherapy. For these patients an alternative therapy would be needed.
The risk of side effects is higher than in patients undergoing first-choice therapy due to radiation damage to the tissues but compares very favourably with other salvage techniques.