What is Prostate Cryotherapy?

Prostate cryotherapy is a surgical procedure that involves the use of cold temperatures to freeze and destroy cancerous cells in the prostate. This procedure can be done on men who have an early stage of prostate cancer that has not metastasized to other tissue. It also could be an option for patients who are not healthy enough for invasive surgery.

When a patient undergoes prostate cryotherapy, a doctor inserts needles into the prostate and injects a cold gas, known as argon, into the prostate. The needles allow the doctor to target only the prostate cancer and avoid healthy tissue. Typically, the patient is first given a general anesthetic and then a square grid is placed against the body in the perineum — the space between the scrotum and the anus. This grid has several rows of holes that will hold the needles.

The doctor then uses ultrasound to measure the prostate and determine the exact placement of the needles. Up to 15 needles could be inserted through the holes in the grid. The doctor also will insert temperature probes into the prostate to monitor the freezing.

Once the needles and probes are in place, argon is injected through the first row of needles into the prostate. Typically, the frozen tissue of the prostate will be visible on the ultrasound. The doctor then injects argon through the second row of needles, taking care not to let the argon gas go outside of the prostate.

In order for the prostate cancer cells to be destroyed, the tissue must be frozen quickly and then thawed slowly. Thawing can be done by turning off the argon gas so the tissue can warm on its own. The tissue can also be thawed by injecting a warming gas such as helium through the needles. Prostate cryotherapy is most successful when the doctor completes two freeze and thaw cycles.

After the prostate cancer cells have been destroyed, the tissue is absorbed by the body. Then, it is considered eliminated. If necessary, prostate cryotherapy can be repeated on a patient.

Prostate cryotherapy can have some side effects. If the argon gas comes in contact with the urethra, the urethra will be damaged. To avoid this, the doctor can pass a catheter through the urethra and inject a warming liquid through it. Other side effects include pain, swelling, and impotence. The risk of impotence can be high; typically, this should be discussed with the doctor when considering this procedure.