High intensity focused ultrasound with Focal-One(®) device: Prostate-specific antigen impact and morbidity evaluation during the initial experience.

We report our initial experience in the treatment of prostate cancer (PCa) with high-intensity focused ultrasound (HIFU) using the Focal-One(®) device.

Retrospective review of the prospectively populated database. Between June 2014 to October 2015, 85 patients underwent HIFU (focal/whole-gland) treatment for localized PCa. Preoperative cancer localization was done with multiparametric magnetic resonance imaging (mpMRI) and transperineal mapping biopsies. Treatment was carried out using the Focal-One(®) device under general anesthesia. Oncological follow-up: PSA measurement and control biopsy with mpMRI according to protocol. Questionnaire-based functional outcome assessment was done. Complications were reported using Clavien classification.

The median PSA was 7.79ng/ml (IQR 6.32-9.16), with a median prostate volume of 38cc (IQR: 33-49.75). Focal and whole-gland therapy was performed in 64 and 21 patients respectively. Ten patients received salvage HIFU. Complications were encountered in 15% of cases, all Clavien 2 graded. Mean hospital stay was 1.8 days (0-7) and bladder catheter was removed on day 2 (1-6). Mean percentage reduction of PSA was 54%. Median follow-up was 3 months (IQR: 2-8). Functional outcomes: All patients were continents at 3 months and potency was maintained in 83% of the preoperatively potent.

Focal-One(®) HIFU treatment appears to be a safe procedure with few complications. Functional outcomes proved no urinary incontinence and sexual function were maintained in 83%.

Actas urologicas espanolas. 2016 Aug 16 [Epub ahead of print]

J I Perez-Reggeti, R Sanchez-Salas, A Sivaraman, E Linares Espinos, A E de Gracia-Nieto, E Barret, M Galiano, F Rozet, A Fregeville, R Renard-Penna, N Cathala, A Mombet, D Prapotnich, X Cathelineau

Departamento de Urología, Institut Mutualiste Montsouris, París, Francia., Departamento de Urología, Institut Mutualiste Montsouris, París, Francia. Electronic address: ., Departamento de Radiología, Institut Mutualiste Montsouris, París, Francia., Departamento de Radiología, Pitié-Salpêtrière Hospital, París, Francia.