Editorial Comment to Transurethral resection of the prostate immediately after high‐intensity focused ultrasound treatment for prostate cancer

Abstract

Recently, the trend in all surgical disciplines has been toward less invasive treatments. High-intensity focused ultrasound (HIFU) is a non-invasive therapy for prostate cancer that has been investigated for more than 20 years. More than 30 000 patients with localized prostate cancer have been treated worldwide. As adverse events, urinary retention, bladder neck-contracture and urethral stricture have been frequently seen after HIFU. The authors reported that a small volume of resection of the prostate tissue by transurethral resection of the prostate (TURP) immediately after HIFU using the Sonablate device significantly reduced catheterization time between the HIFU-only group and the HIFU + TURP group (12 days vs 5 days median, P < 0.0001).1 In addition, the occurrence rate of acute urinary retention, epididymitis and urethral stricture are significantly decreased. It is important not only to have a good clinical outcome but also to reduce the rate of morbidities after HIFU to keep a quality of life of each patient. Recently, HIFU has delivered treatment as salvage therapy after radiation failure, anastomotic site recurrence after radical prostatectomy and focal therapy.2–4 Although there is a wide choice of treatment for organ-confined prostate cancer, HIFU is an attractive choice for men willing to choose less invasive options. Technological advances, as well as cultural and economic vectors, have caused a dramatic shift from traditional open, radical prostatectomy to minimally invasive techniques.