Urinary outcomes of new ultra-minimally invasive treatments for prostate cancers.

The aim of this narrative review is to evaluate the current available literature on urinary outcomes following cryotherapy and high-intensity focused ultrasound (HIFU) for localized prostate cancer (PCa).

The available literature is heterogeneous in terms of intervention modalities and assessment of urinary outcome measures. Nevertheless, ultra-minimally invasive treatments seem to provide good urinary outcomes. Technological advancement and the adoption of more conservative ablation templates allow for a further reduction of toxicity and better preservation of urinary function. Urinary incontinence occurs in 0-10% of the patients and, is mostly transient. Voiding and storage lower urinary tract symptoms (LUTS) mostly occur in the early postoperative period and rarely require surgical treatment. Focal therapies performed with a salvage intent after external beam radiotherapy have a significantly higher impact on patient's urinary function.

Ultra-minimally invasive treatment for PCa show a good safety profile concerning urinary function, but consensus on when and how best to assess this is still lacking. Efforts should be made to standardize the report of preoperative and postoperative urinary function to provide higher level of evidence.

Current opinion in urology. 2023 Aug 23 [Epub ahead of print]

Sabrina De Cillis, Nadir Osman, Cyrille Guillot-Tantay, Francois Hervé, Mikolaj Przydacz, Manuela Tutolo, Gokhan Culha, Paolo Geretto, Fabiana Cancrini, Enrico Checcucci, Veronique Phé, EAU-YAU Functional Urology and Uro-techology Group

Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, Orbassano (TO), Italy., Department of Urology, Royal Hallamshire Hospital, Sheffield, UK., Hôpital Foch, Service d'Urologie, Suresnes, France., Department of Urology, Ghent University Hospital, Ghent, Belgium., Department of Urology, Jagiellonian University Medical College, 30-688 Krakow, Poland., Division of Oncology, Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy., Department of Urology, University of Health Sciences, Prof. Dr Cemil Tascioglu City Hospital, Istanbul, Turkey., Division of Neuro-Urology, Department of Surgical Sciences, Città della Salute e della Scienza, University of Turin, Turin, Italy., Department of Medical and Surgical Sciences and Translational Medicine, Sapienza University, Rome, Italy., Department of Surgery, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy., Department of Urology, Tenon Academic Hospital, AP-HP, Sorbonne University, Paris, France.