MedWire News: Patients who have an external sphincter temperature of 23°C or less during cryoablation are significantly more likely to experience urgency and/or frequency of urinary retention after cryoablation, study findings show.
David Levy (Glickman Urological and Kidney Institute, Cleveland, Ohio, USA) comments: “This study is the first to use thermocouple data to study factors that might have an affect on procedure-related morbidity after cryoablation of the prostate.”
Levy made a retrospective analysis of the records of 58 patients treated with prostate cryoablation from October 2005 through April 2009. Of the 58 patients, 22 (37.9%) manifested postcryoablation urgency and frequency (n=13) requiring medical attention or retention (n=9).
On multivariate analysis, age and an external sphincter temperature of 23°C or less were associated with voiding frequency, urgency, or retention (odds ratio=6.26).
Levy comments in the journal Urology: “The finding of an association of altered voiding function with colder external sphincter temperatures suggests that a limitation in the extent of freezing near the external sphincter might have an effect on procedure-related morbidity.”
He adds: “A history of prior radiation therapy was not a statistically significant factor in postcryoablation voiding dysfunction on univariate or multivariate analysis.
“Although the difference in procedure-related morbidity for the radiation population cannot be overemphasized, it is recognized that the current study may be underpowered to delineate a potentially statistically significant effect of prior radiation therapy on alterations in voiding function after cryoablation, and only further study will explain this.”
While acknowledging limitations to this study, including its retrospective nature and the placement of thermocouples in and around the prostate gland, Levy recommends further efforts at more standardized assessment of potential factors that might have an effect on voiding function after cryoablation.
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