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Urology
 
HIFU - High Intensity Focused Ultrasound Treatment of Prostate Tumour / Tumor
 
 
 
 
 HIFU - HIGH INTENSITY FOCUSED ULTRASOUND TREATMENT FOR PROSTATE CARCINOMA
 
 The Method
 Through a probe entering into the rectum a focused and highly concentrated field of ultrasound waves is applied to the prostate in bladder exit area. The focusing of the ultrasound field generates local temperatures up to 95 C that will precisely target the diseased tissue (coagulation through heat).
 
 The technology
 German Medicine is able to arrange treatment with various generations of HIFU machines, amongst them the lastest model Sonablate 500, developed by Focus Surgery, USA with the following features:
 3D representation of prostate
 simultaneous HIFU therapy
 variable focus lengths for individual adaptation to target area
 visual image guidance through integrated diagnostic ultrasound feature
 RDMTM rectal wall distance assessment
 HIFU Rim (Reflectivity Index Measurement)
 Scalable digital platform
 Active Cooling "Sonachill"
 multifunctional arm for fixation of probe
 data processing through page printer SVHS and CD-Rom Space-Savings-Streamline footprint
 
 Therapy regime
 Light slumber anaesthesia combined with local anaesthesia of prostate area (usually peridurally). Patient is lying on his back with slightly bent knees, whilst the probe approaches the prostate through the rectum usually without any challenges. Now the target area is chosen and irradiated by computer-guide focused sound the surgoen simultaneously controlling progress of treatment through the ultrasound imaging feature. The procedure takes 50-60 minutes depending on size and weight of area treated. A balloon catheter introduced into the urethra can assist in exact targeting.
 After the treatment patients rest for about 30 minutes, often take a small meal and leave the clinic about an hour later. After a short post-op follow-up on the next day patients are discharged.
 
 Experience and Evidence
 By now more than patients worldwide have been treated with HIFU. The results are convincing compared to TUR with regard to risks and side effects (see: Noninvasive Surgery of Prostate Tissue by High Intensity Focused Ultrasound: An Updated Report, N.T. Sanghvi, European Journal of Ultrasound 9, 1999)
 
 Risks and Side Effects
 After the operation a catheter has to be worn for a few days to prevent possible swelling fo prostate leading to blcoking of urine. After removal of catheter a state of irritation can ensure for a few days usually abating quickly under various simple therapeutical measures.
 Retrogade ejaculation and distrubances of potence are extremely rare (less than 1%) compared to TUR surgery. Other known TUR complications will not appear at all with this method. Summing up the advantages:
 Improvement of maximum flow of urine
 Reduction of remaining urine by more than 50%
 can be performed as day case
 treatment avoids direct touching
 no general anaesthesia required
 short treatment period
 only minor complaints after treatment