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Prostate Cancer Survivorship

What is Prostate Cancer Survivorship?

Prostate cancer survivorship refers to the period of time after a person has completed treatment for prostate cancer.
It encompasses the physical, emotional, and psychosocial aspects of life following cancer treatment. Survivors may face long-term effects of treatment, such as urinary incontinence, erectile dysfunction, and emotional distress. Prostate-specific follow-up care is essential during this phase, including regular monitoring of prostate-specific antigen (PSA) levels, check-ups, and addressing survivorship issues. Supportive care measures, such as lifestyle modifications, rehabilitation, counselling, and support groups, can help survivors manage the challenges and improve their quality of life. Survivorship also emphasises the importance of ongoing surveillance and maintaining overall well-being.
1. What are complications after Radical prostatectomy?
Post-prostatectomy complications refer to the potential adverse effects that can occur after surgical removal of the prostate gland, usually for the treatment of prostate cancer. Common complications include urinary incontinence, where control over urine flow is compromised, and erectile dysfunction, the inability to achieve or maintain an erection. These complications can have a significant impact on a man’s quality of life and emotional well-being. Other potential complications include urinary tract infections, urethral strictures, bladder neck contracture, and lymphedema. Rehabilitation programs, including pelvic floor exercises and medications, are often recommended to help manage these complications and improve recovery outcomes for prostatectomy patients.
2. What are complications after External Beam Radiotherapy?
Radiation complications for prostate cancer refer to the potential side effects and adverse reactions that can occur as a result of external beam radiation therapy. Common complications include urinary problems such as increased frequency, urgency, and difficulty urinating. Erectile dysfunction and bowel disturbances, such as diarrhoea or rectal bleeding, are also possible. Additionally, radiation therapy can cause fatigue, skin irritation or burns in the treatment area, and long-term effects like bladder or rectal damage. Regular follow-up and monitoring are important to detect and manage these complications. Supportive measures, such as medications, lifestyle modifications, and counselling, may be utilised to mitigate the impact of radiation complications on the patient’s overall well-being.
3. What are complications after Brachytherapy?
Complications after brachytherapy, a form of radiation therapy for cancer treatment, can arise due to the placement of radioactive sources (seeds) near or within the tumour site. Common complications include urinary issues like increased frequency, urgency, and discomfort during urination. Erectile dysfunction, bowel problems, and rectal irritation may also occur. Inflammation and swelling in the treated area, known as radiation cystitis or proctitis, are possible complications. Additionally, long-term effects such as urinary strictures, urinary incontinence, and secondary malignancies are potential concerns. Close monitoring and follow-up care are essential to manage and address these complications, ensuring the well-being and quality of life of the patient.
4. What are complications after HIFU-therapy?
Complications after high-intensity focused ultrasound (HIFU) therapy for prostate cancer can occur as a result of the tissue ablation with ultrasound energy. Common complications include urinary problems such as urinary incontinence, urinary retention, or urinary tract infections. Erectile dysfunction is also a potential complication. Additionally, HIFU therapy can lead to bowel disturbances, rectal irritation, or rectal bleeding. In rare cases, damage to surrounding tissues or structures, such as the rectum or urethra, can lead to rectal or urethral injury. Regular follow-up and monitoring are crucial to detect and manage these complications effectively. Supportive measures, including medication, lifestyle modifications, and rehabilitation, may be recommended to address the complications and improve the overall well-being of the patient.
5. What are complications after Cryotherapy?
Complications after cryotherapy for prostate cancer can arise due to the freezing and thawing process used to destroy cancer cells. Common complications include urinary problems such as urinary incontinence, urinary retention, or urinary tract infections. Erectile dysfunction is another potential complication. Inflammation of the urethra or bladder, known as urethritis or cystitis, may occur. In rare cases, damage to surrounding tissues or structures, such as the rectum or urethra, can lead to rectal or urethral injury. Regular follow-up care and monitoring are essential to detect and manage these complications. Treatment options, such as medications, lifestyle modifications, or additional interventions, may be recommended to address specific complications and improve patient outcomes.

What this page informs you about

1. Complications after Radical prostatectomy
  • 1.1
    erectile dysfunction
  • 1.2.
    urinary stress incontinence
  • 1.3.
    anastomotic stricture (bladder neck contracture)
  • 1.4.
    bulbar urethral stricture
  • 1.5.
    lymphoedema
  • 1.6.
    uro-rectal fistula
Skip to the section
2. Complications after External Beam Radiotherapy
  • 2.1.
    radiation cystitis
  • 2.2.
    radiation proctitis
  • 2.3.
    erectile dysfunction
  • 2.4.
    urinary urge incontinence
  • 2.5.
    prostatic urethral strictures
  • 2.6.
    lymphoedema
  • 2.7.
    uro-rectal fistula
  • 2.8.
    uro-symphyseal fistula
Skip to the section
3. Complications after Brachytherapy
  • 3.1.
    radiation cystitis
  • 3.2.
    radiation proctitis
  • 3.3.
    erectile dysfunction
  • 3.4.
    urinary urge incontinence
  • 3.5.
    prostatic urethral strictures
  • 3.6.
    uro-rectal fistula
Skip to the section
4. Complications after HIFU-therapy
  • 4.1.
    urinary retention
  • 4.2.
    urinary infections
  • 4.3.
    erectile dysfunction
  • 4.4.
    urinary incontinence
  • 4.5.
    uro-rectal fistula
Skip to the section
5. Complications after Cryotherapy
  • 5.1.
    urinary retention
  • 5.2.
    urinary infection
  • 5.3.
    erectile dysfunction
  • 5.4.
    urinary incontinence
  • 5.5.
    uro-rectal fistula
Skip to the section

1. Complications after Radical prostatectomy

1.1 Symptoms of post-prostatectomy “erectile dysfunction” and its treatment
The symptoms of post-prostatectomy erectile dysfunction (ED) include the inability to achieve or maintain an erection firm enough for sexual intercourse. Patients may experience a significant decrease in sexual desire and overall sexual satisfaction.
Treatment options for post-prostatectomy ED vary depending on the severity and individual patient factors. They can include oral medications like phosphodiesterase-5 inhibitors (e.g., Viagra), vacuum erection devices, penile injections, intraurethral suppositories, or surgical interventions such as penile implants. Additionally, counselling, psychosexual therapy, and lifestyle modifications (such as regular exercise, healthy diet, and smoking cessation) may also play a role in the overall management and improvement of post-prostatectomy ED.
1.2 Symptoms of post-prostatectomy “urinary stress incontinence” and its treatment

The symptoms of post-prostatectomy urinary stress incontinence involve the involuntary leakage of urine during physical activities that increase abdominal pressure, such as coughing, sneezing, laughing, or lifting. Patients may experience varying degrees of urine leakage, ranging from mild to severe.

Treatment options for post-prostatectomy urinary stress incontinence include pelvic floor muscle exercises (Kegel exercises) to strengthen the muscles that control urinary function. Other non-surgical interventions include the use of absorbent pads or external devices like penile clamps or condom sheath drainage bags. In more severe cases, surgical options such as sling procedures or artificial urinary sphincter implantation may be considered to restore urinary control. The choice of treatment depends on the severity and impact of urinary incontinence on the patient’s quality of life.

1.3 Symptoms of post-prostatectomy “anastomotic stricture (bladder neck contracture)” and its treatment

The symptoms of post-prostatectomy anastomotic stricture, also known as bladder neck contracture, include difficulty urinating, weak urine flow, increased frequency of urination, urinary urgency, and incomplete bladder emptying. Patients may also experience recurrent urinary tract infections.

Treatment options for anastomotic strictures vary depending on the severity and location of the stricture. Non-surgical interventions may include urethral dilation or periodic catheterisation to widen the narrowed area. In more severe cases, surgical procedures such as direct visual internal urethrotomy (DVIU), or reconstructive surgeries like urethroplasty or bladder neck reconstruction may be necessary to restore proper urinary function. Regular follow-up care and monitoring are essential to manage and address post-prostatectomy anastomotic strictures effectively.

1.4 Symptoms of post-prostatectomy “bulbar urethral stricture” and its treatment

The symptoms of post-prostatectomy bulbar urethral stricture include difficulty urinating, weak urine flow, increased frequency of urination, urinary urgency, and straining during urination. Patients may also experience recurrent urinary tract infections and urinary retention.

Treatment options for bulbar urethral strictures depend on the severity and location of the stricture. Non-surgical interventions may include urethral dilation or periodic catheterisation to widen the narrowed area. In more complex cases, surgical procedures such as urethroplasty, which involves reconstructing the affected urethral segment, may be necessary to restore proper urine flow. Regular follow-up care and monitoring are essential to manage and address post-prostatectomy bulbar urethral strictures effectively.

1.5 Symptoms of post-prostatectomy “lymphoedema” and its treatment

Post-prostatectomy lymphedema refers to the swelling and accumulation of lymphatic fluid in the lower limbs or genital area after surgical removal of the prostate gland and lymph nodes. Symptoms may include swelling, heaviness, tightness, discomfort, or pain in the affected area. Restricted mobility and decreased quality of life may also occur.

Treatment for post-prostatectomy lymphedema typically involves a combination of therapies, including manual lymphatic drainage, compression garments or bandaging, exercise, skin care, and lifestyle modifications. These aim to reduce swelling, improve lymphatic flow, manage symptoms, and enhance overall well-being. It is important for individuals to receive appropriate assessment, education, and ongoing support from healthcare professionals specializing in lymphedema management.

1.6 Symptoms of post-prostatectomy “uro-rectal fistula” and its treatment

Post-prostatectomy uro-rectal fistula refers to an abnormal connection between the urethra and rectum, leading to the passage of urine into the rectum. Symptoms may include recurrent urinary tract infections, passage of urine or gas through the rectum, faecal incontinence, rectal pain, and discomfort.

Treatment for uro-rectal fistula is extremely complex and requires multidisciplinary care. It typically involves surgical repair, which aims to close the fistula and reconstruct the affected tissues, often with muscle interposition flaps. Faecal and urinary diversion may be necessary to support rectal healing after surgical repair, depending on the severity and location of the fistula. Antibiotics may be prescribed to prevent or treat infections. Post-operative Intensive care and regular post-operative monitoring and follow-up are essential to assess healing, manage complications, and optimise outcomes for individuals with uro-rectal fistula.

2. Complications after External Beam Radiotherapy

2.1 Symptoms of post-external beam radiotherapy “radiation cystitis” and its treatment
Post-external beam radiotherapy, radiation cystitis refers to inflammation of the bladder caused by radiation treatment. Symptoms may include increased frequency and urgency of urination, burning or pain during urination, blood in the urine, and bladder discomfort or spasms.

Treatment for radiation cystitis focuses on managing symptoms and promoting healing. This may involve medications to alleviate pain, reduce inflammation, and control urinary symptoms. Lifestyle modifications such as increasing fluid intake and avoiding irritants like caffeine and alcohol may be recommended. In more severe cases, advanced interventions like hyperbaric oxygen therapy or surgical procedures may be considered. Regular follow-up and monitoring are crucial to assess the progression and response to treatment.
2.2. Symptoms of post-external beam radiotherapy “radiation proctitis” and its treatment

Post-external beam radiotherapy, radiation proctitis refers to inflammation and damage to the rectal tissues caused by radiation treatment. Symptoms may include rectal bleeding, diarrhoea, urgency to defecate, pain or discomfort in the rectal area, and mucus discharge from the rectum.

Treatment for radiation proctitis focuses on managing symptoms and promoting healing. This may involve medications to control diarrhoea, reduce inflammation, and alleviate pain. Dietary modifications, such as increasing fibre intake and avoiding irritants, may be recommended. Advanced interventions like hyperbaric oxygen therapy or endoscopic procedures may be considered for severe cases. Regular follow-up and monitoring are essential to assess response to treatment and address any complications.

2.3 Symptoms of post-external beam radiotherapy “erectile dysfunction” and its treatment

Post-external beam radiotherapy, erectile dysfunction (ED) refers to the inability to achieve or maintain an erection sufficient for sexual intercourse after radiation treatment. Symptoms include difficulty in obtaining or sustaining erections, reduced sexual desire, and decreased overall sexual satisfaction.

Treatment for radiation-induced ED varies and may include oral medications like phosphodiesterase-5 inhibitors (e.g., Viagra), vacuum erection devices, penile injections, or intraurethral suppositories. Counselling, psychosexual therapy, and lifestyle modifications (such as regular exercise, healthy diet, and smoking cessation) may also be beneficial. It’s important for individuals to discuss their concerns with healthcare providers to explore the most appropriate and effective treatment options for post-radiation ED.

2.4 Symptoms of post-external beam radiotherapy “urinary urge incontinence ” and its treatment

Post-external beam radiotherapy, urinary urge incontinence refers to the involuntary leakage of urine accompanied by a sudden and intense urge to urinate. Symptoms may include frequent urination, sudden urges to urinate, and the inability to hold urine long enough to reach a restroom.

Treatment for post-radiotherapy urinary urge incontinence focuses on managing symptoms and improving bladder control. This may involve lifestyle modifications such as timed voiding, bladder training exercises, and pelvic floor muscle exercises (Kegels). Medications to relax the bladder muscle or control excessive bladder contractions may be prescribed. In more severe cases, advanced interventions like bladder BOTOX injections may be considered. Regular follow-up and monitoring are important to assess response to treatment and adjust the management plan accordingly.

2.5 Symptoms of post-external beam radiotherapy “prostatic urethral strictures ” and its treatment

Post-external beam radiotherapy, prostatic urethral strictures refer to the narrowing of the urethra that can occur as a result of radiation treatment for prostate cancer. Symptoms may include a weak urine stream, difficulty initiating urination, increased frequency of urination, urinary retention, and recurrent urinary tract infections.

Treatment for post-radiotherapy prostatic urethral strictures may involve various interventions, such as urethral dilation to widen the narrowed area, urethrotomy (surgical incision) or resection to remove scarred prostatic tissue. In more severe cases, salvage prostatectomy may be considered but carries a higher risk of complications. Close monitoring and follow-up care are crucial to address any complications and optimise functional outcomes.

2.6 Symptoms of post-external beam radiotherapy “lymphoedema” and its treatment

Post-external beam radiotherapy, lymphoedema refers to the swelling and accumulation of lymphatic fluid in the affected area due to radiation treatment. Symptoms of lymphoedema may include persistent swelling, heaviness or tightness in the limbs, decreased mobility, discomfort, and skin changes.

Treatment for post-radiotherapy lymphoedema aims to manage symptoms and improve lymphatic flow. This may involve techniques such as manual lymphatic drainage, compression therapy with bandages or garments, exercise programs, and skin care. Additionally, lifestyle modifications like weight management and avoiding activities that exacerbate swelling may be recommended. Regular follow-up and ongoing management are essential to monitor the progression of lymphoedema and optimise treatment outcomes.

2.7 Symptoms of post-external beam radiotherapy “uro-rectal fistula” and its treatment

Post-external beam radiotherapy, a uro-rectal fistula refers to an abnormal connection between the urinary tract and the rectum, often caused by radiation-induced tissue damage. Symptoms of a uro-rectal fistula may include the passage of urine or gas through the rectum, faecal or urinary incontinence, recurrent urinary tract infections, rectal pain, and discomfort.

Treatment for uro-rectal fistula after external beam radiotherapy is extremely complex and requires multidisciplinary care. It typically involves surgical repair, which aims to close the fistula and reconstruct the affected tissues. Faecal and urinary diversion may be necessary to support rectal healing after surgical repair, depending on the severity and location of the fistula. The specific surgical approach depends on the size and location of the fistula, but salvage radical prostatectomy may be necessary.

Antibiotics may be prescribed to prevent or treat infections. Post-operative Intensive care and regular post-operative monitoring and follow-up are essential to assess healing, manage complications, and optimise outcomes for individuals with uro-rectal fistula.

2.8 Symptoms of post-external beam radiotherapy “uro-symphyseal fistula” and its treatment

Post-external beam radiotherapy, a uro-symphyseal fistula refers to an abnormal connection between the urinary tract and the symphysis pubis (pelvic bone) due to radiation-induced tissue damage. Symptoms of a uro-symphyseal fistula may include the passage of urine into the pelvic bone, urinary incontinence, recurrent urinary tract infections, and severe debilitating pelvic pain.

Uro-symphyseal fistulas predominantly occur when surgical treatment of an irradiated anastomotic stricture following radical prostatectomy involves the incision or resection of scar tissue. This intervention can lead to the leakage of urine into the pubic bone area, which is within the field of external beam radiotherapy.

Treatment for a uro-symphyseal fistula is extremely complex and requires multidisciplinary care. The specific surgical approach depends on the size and location of the fistula, but in most cases permanent urinary diversion (ileal conduit) is necessary with partial pubectomy and omental interposition. Antibiotics may be prescribed to prevent or treat infections. Post-operative Intensive care and regular post-operative monitoring and follow-up are essential to assess healing, manage complications, and optimise outcomes for individuals with uro-symphyseal fistula.

3. Complications after Brachytherapy

3.1 Symptoms of post-brachytherapy “radiation cystitis” and its treatment
Post-brachytherapy, radiation cystitis refers to inflammation and damage to the bladder caused by radiation treatment. Symptoms may include increased urinary frequency, urgency, pain or discomfort during urination, blood in the urine (haematuria), and bladder spasms.

Treatment for radiation cystitis aims to manage symptoms and promote healing. This may involve medications to alleviate pain and inflammation, bladder instillations of medications to soothe the bladder lining, and lifestyle modifications such as increasing fluid intake and avoiding irritants like caffeine and alcohol. In more severe cases, advanced interventions like hyperbaric oxygen therapy or surgical procedures may be considered. Regular follow-up and monitoring are important to assess response to treatment and address any complications.
3.2 Symptoms of post-brachytherapy “radiation proctitis” and its treatment

Post-brachytherapy, radiation proctitis refers to inflammation and damage to the rectum caused by radiation treatment. Symptoms may include rectal bleeding, diarrhoea, urgency to defecate, pain or discomfort in the rectal area, and mucus discharge from the rectum.

Treatment for radiation proctitis focuses on managing symptoms and promoting healing. This may involve medications to control diarrhoea, reduce inflammation, and alleviate pain. Dietary modifications, such as increasing fibre intake and avoiding irritants, may be recommended. Advanced interventions like hyperbaric oxygen therapy may be considered for severe cases. Regular follow-up and monitoring are essential to assess response to treatment and address any complications.

3.3. Symptoms of post-brachytherapy “erectile dysfunction” and its treatment

Post-brachytherapy, erectile dysfunction (ED) refers to the inability to achieve or maintain an erection sufficient for sexual intercourse after the radiation treatment. Symptoms of post-brachytherapy ED include difficulty in obtaining or sustaining erections, reduced sexual desire, and decreased overall sexual satisfaction.

Treatment options for radiation-induced ED may include oral medications such as phosphodiesterase-5 inhibitors (e.g., Viagra), vacuum erection devices, penile injections, or intraurethral suppositories. Counselling, psychosexual therapy, and lifestyle modifications (such as regular exercise, healthy diet, and smoking cessation) may also be beneficial. It’s important for individuals to discuss their concerns with healthcare providers to explore the most appropriate and effective treatment options for post-brachytherapy ED.

3.4 Symptoms of post-brachytherapy “urinary urge incontinence” and its treatment

Post-brachytherapy, urinary urge incontinence refers to the involuntary leakage of urine accompanied by a sudden and intense urge to urinate. Symptoms may include frequent urination, sudden urges to urinate, and the inability to hold urine long enough to reach a restroom.

Treatment for post-brachytherapy urinary urge incontinence focuses on managing symptoms and improving bladder control. This may involve lifestyle modifications such as timed voiding, bladder training exercises, and pelvic floor muscle exercises (Kegels). Medications to relax the bladder muscle or control excessive bladder contractions may be prescribed. In more severe cases, advanced interventions like sacral nerve stimulation or injectable bulking agents may be considered. Regular follow-up and monitoring are important to assess response to treatment and adjust the management plan accordingly.

3.5 Symptoms of post-brachytherapy “prostatic urethral strictures” and its treatment

Post-brachytherapy, prostatic urethral strictures refer to the narrowing of the urethra that can occur as a result of radiation treatment for prostate cancer. Symptoms of post-brachytherapy prostatic urethral strictures may include a weak urine stream, difficulty initiating urination, increased frequency of urination, urinary retention, and recurrent urinary tract infections.

Treatment for post-brachytherapy prostatic urethral strictures may involve various interventions, such as urethral dilation to widen the narrowed area, urethrotomy (surgical incision), or resection to remove scar tissue to maintain the urethral patency. In more severe cases, salvage radical prostatectomy may be considered to restore normal urinary flow. Close monitoring and follow-up care are crucial to address any complications and optimise treatment outcomes.

3.6 Symptoms of post-brachytherapy “uro-rectal fistula” and its treatment

Post-brachytherapy, a uro-rectal fistula refers to an abnormal connection between the urinary tract and the rectum, often caused by radiation-induced tissue damage. Symptoms of a uro-rectal fistula may include the passage of urine or gas through the rectum, faecal or urinary incontinence, recurrent urinary tract infections, rectal pain, and discomfort.

Treatment for uro-rectal fistula after brachytherapy is extremely complex and requires multidisciplinary care. It typically involves surgical repair, which aims to close the fistula and reconstruct the affected tissues. Faecal and urinary diversion may be necessary to support rectal healing after surgical repair, depending on the severity and location of the fistula. The specific surgical approach depends on the size and location of the fistula, but salvage radical prostatectomy may be necessary.

Antibiotics may be prescribed to prevent or treat infections. Post-operative Intensive care and regular post-operative monitoring and follow-up are essential to assess healing, manage complications, and optimise outcomes for individuals with uro-rectal fistula.

4. Complications after HIFU-therapy

4.1 Symptoms of post-HIFU “urinary retention” and its treatment

Post-High-Intensity Focused Ultrasound (HIFU) urinary retention refers to the inability to fully empty the bladder after undergoing HIFU treatment for prostate cancer. Symptoms may include difficulty initiating urination, weak urine flow, a feeling of incomplete bladder emptying, and the need to strain to urinate.

Treatment for post-HIFU urinary retention may involve the use of medications to relax the muscles around the prostate and improve urine flow. In some cases, temporary catheterisation may be required to relieve the immediate obstruction. Close monitoring by healthcare professionals is essential to address urinary retention promptly and provide appropriate interventions to alleviate symptoms and restore normal bladder function.

4.2 Symptoms of post-HIFU “urinary infections” and its treatment

Post-High-Intensity Focused Ultrasound (HIFU) urinary infections can occur as a potential complication after HIFU treatment for prostate cancer. Symptoms of urinary infections may include frequent urination, urgency, pain or discomfort during urination, cloudy or bloody urine, and lower abdominal or pelvic pain.

Treatment for post-HIFU urinary infections typically involves a course of antibiotics to target the infection-causing bacteria. It is crucial for patients to promptly report any symptoms of a urinary infection to their healthcare provider for proper diagnosis and treatment. Adequate hydration and completing the prescribed antibiotic regimen are important measures to manage and prevent urinary infections after HIFU treatment.

4.3 Symptoms of post-HIFU “erectile dysfunction” and its treatment

Post-High-Intensity Focused Ultrasound (HIFU) erectile dysfunction refers to the inability to achieve or maintain an erection sufficient for sexual intercourse after undergoing HIFU treatment for prostate cancer. Symptoms may include difficulty in achieving or maintaining firm erections, reduced sexual desire, and overall dissatisfaction with sexual function.

Treatment options for post-HIFU erectile dysfunction may include oral medications such as phosphodiesterase type 5 inhibitors (e.g., Viagra, Cialis), vacuum erection devices, penile injections, or surgical interventions like penile implants. It is important for patients to discuss their concerns with their healthcare provider, who can provide appropriate counselling, guidance, and treatment options to address post-HIFU erectile dysfunction and improve sexual function and quality of life.

4.4 Symptoms of post-HIFU “urinary incontinence” and its treatment

Post-High-Intensity Focused Ultrasound (HIFU) urinary incontinence refers to the involuntary loss of urine after undergoing HIFU treatment for prostate cancer. Symptoms may include leakage of urine during physical activity, coughing, sneezing, or an urgent need to urinate. The severity of incontinence can vary from mild to more significant leakage.

Treatment options for post-HIFU urinary incontinence may include pelvic floor exercises to strengthen the muscles that control urination, bladder training techniques, lifestyle modifications, and the use of protective pads or absorbent products. In more severe cases, surgical interventions such as the placement of an artificial urinary sphincter or a sling procedure may be considered to improve urinary control and quality of life. Consulting with a healthcare provider is crucial to determine the most appropriate treatment approach.

4.5 Symptoms of post-HIFU “uro-rectal fistula” and its treatment

Post-High-Intensity Focused Ultrasound (HIFU) uro-rectal fistula refers to an abnormal connection between the urinary tract and the rectum following HIFU treatment for prostate cancer. Symptoms may include the passage of urine or gas through the rectum, faecal matter in the urine, urinary or rectal infections, abdominal pain, and changes in bowel habits.

Treatment for uro-rectal fistula after HIFU is extremely complex and requires multidisciplinary care. It typically involves surgical repair, which aims to close the fistula and reconstruct the affected tissues. Faecal and urinary diversion may be necessary to support rectal healing after surgical repair, depending on the severity and location of the fistula. The specific surgical approach depends on the size and location of the fistula, but salvage radical prostatectomy may be necessary.

Antibiotics may be prescribed to prevent or treat infections. Post-operative Intensive care and regular post-operative monitoring and follow-up are essential to assess healing, manage complications, and optimise outcomes for individuals with uro-rectal fistula.

5. Complications after Cryotherapy

5.1 Symptoms of post-cryotherapy “urinary retention” and its treatment

Post-cryotherapy urinary retention refers to the inability to fully empty the bladder after cryotherapy treatment, a procedure used for treating prostate cancer. Symptoms of urinary retention may include difficulty starting urination, weak urine flow, frequent urination, a feeling of incomplete emptying, and the need to strain to urinate.

Treatment options for post-cryotherapy urinary retention may include medications to relax the muscles around the prostate and improve urine flow, catheterization to relieve immediate obstruction, or in some cases, surgical intervention to address any persistent blockage. It is important for patients to report any urinary symptoms to their healthcare provider to receive appropriate evaluation and management.

5.2 Symptoms of post-cryotherapy “urinary infections” and its treatment

Post-cryotherapy urinary infections, also known as urinary tract infections (UTIs), can occur as a complication after cryotherapy treatment for prostate cancer. Symptoms of urinary infections may include frequent urination, a strong urge to urinate, pain or discomfort during urination, cloudy or bloody urine, and lower abdominal or pelvic pain.

Treatment for post-cryotherapy urinary infections typically involves a course of antibiotics to target the infection-causing bacteria. It is important for patients to promptly report any symptoms of a urinary infection to their healthcare provider to receive appropriate diagnosis and treatment. Adequate hydration and maintaining good urinary hygiene practices can also help prevent urinary infections after cryotherapy.

5.3 Symptoms of post-cryotherapy “erectile dysfunction” and its treatment

Post-cryotherapy erectile dysfunction (ED) refers to the difficulty or inability to achieve and maintain an erection after cryotherapy treatment for prostate cancer. Symptoms may include a decreased ability to achieve or sustain firm erections, reduced sexual desire, and overall dissatisfaction with sexual function.

Treatment options for post-cryotherapy ED may include oral medications such as phosphodiesterase type 5 inhibitors, vacuum erection devices, penile injections, or surgical interventions like penile implants. It is important for patients to discuss their concerns with their healthcare provider, who can provide appropriate counseling, guidance, and treatment options to address post-cryotherapy erectile dysfunction and improve sexual function and quality of life.

5.4 Symptoms of post-cryotherapy ” urinary incontinence ” and its treatment

Post-cryotherapy urinary incontinence refers to the involuntary loss of urine after cryotherapy treatment for prostate cancer. Symptoms may include leakage of urine during physical activity, coughing, sneezing, or an urgent need to urinate. The severity of incontinence can vary from mild to more significant leakage.

Treatment options for post-cryotherapy urinary incontinence may include pelvic floor exercises to strengthen the muscles that control urination, bladder training techniques, lifestyle modifications, and the use of protective pads or absorbent products. In more severe cases, surgical interventions such as the placement of an artificial urinary sphincter or a sling procedure may be considered to improve urinary control and quality of life. Consulting with a healthcare provider is crucial to determine the most appropriate treatment approach.

5.5 Symptoms of post-cryotherapy “uro-rectal fistula” and its treatment

Post-cryotherapy uro-rectal fistula refers to an abnormal connection between the urinary tract and the rectum following cryotherapy treatment for prostate cancer. Symptoms may include the passage of urine or gas through the rectum, faecal matter in the urine, urinary or rectal infections, abdominal pain, and changes in bowel habits.

Treatment for uro-rectal fistula after cryotherapy is extremely complex and requires multidisciplinary care. It typically involves surgical repair, which aims to close the fistula and reconstruct the affected tissues. Faecal and urinary diversion may be necessary to support rectal healing after surgical repair, depending on the severity and location of the fistula. The specific surgical approach depends on the size and location of the fistula, but salvage radical prostatectomy may be necessary.

Antibiotics may be prescribed to prevent or treat infections. Post-operative Intensive care and regular post-operative monitoring and follow-up are essential to assess healing, manage complications, and optimise outcomes for individuals with uro-rectal fistula.