Choosing a method of bladder drainage during HIFU-therapy of prostate cancer

Shestaev A.Yu., Protoschak V.V., Sinel'nikov L.M., Kardinalova V.A., Eloev R.A.

Infectious complications represent a serious problem linked to HIFUtherapy, which can slow down the rehabilitation after procedure and lengthen the hospitalization time. Infectious complications stay with approximately 12.5% of all complications and are in general restricted to epididymitis, pyelonephritis and cystitis. The aim of our study was to find out the factors predisposing to the infectious complications. Our study included 98 patients, which underwent HIFU-therapy. In all cases transurethral resection was done before the procedure. All patients were divided between 2 groups: 45 men in group 1 with positive urine culture (>10 CFU/ml) and 53 patients with sterile urine in group 2. These groups consisted of two subgroups – in first one urethral catheterization was carried out for 10 days, in second one – cystostome was inserted with the attempts to restore the voiding starting from the day 3 after ablation. In group 1 patients the frequency of infectious complications was almost 3 times more. Comparative analysis showed that cystostomy tended to increase the rates of epididymitis, pyelonephritis and cystitis by 2.5-3 times in case of positive urine culture. In patients with sterile urine these complications were amplified 1.5-2 times on cystostome. Drawing the conclusion, urethral catheterization is preferred to the cystostomy after HIFU-therapy. Cystostomy is linked to the increased rate of the infectious complications after operation.

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