Open Access

ARTICLE

Partial gland ablation with high intensity focal ultrasound impact on genito-urinary function and quality of life: our initial experience

Ioana Fugaru¹, David Bouhadana¹, Gautier Marcq^2,3, Joseph Moryousef⁴, Alexis Rompré-Brodeur¹, Andrew Meng⁴, Oleg Loutochin¹, George Loutochin¹, Maurice Anidjar¹, Frank Bladou⁵, Rafael Sanchez-Salas¹

1 Division of Urology, Department of Surgery, McGill University, Montreal, Quebec, Canada
2 Department of Urology, Claude Huriez Hospital, CHU Lille, Lille, France
3 Université de Lille, CNRS Inserm, CHU Lille, Institut Pasteur de Lille, Lille, France
4 Faculty of Medicine, McGill University, Montreal, Quebec, Canada
5 Department of Urology, Pellegrin University Hospital, Bordeaux, France
Address correspondence to Dr. Rafael Sanchez-Salas, McGill University Health Centre Glen Site, 1001 Decarie Boulevard, Montreal, QC H4A 3J1 Canada

Canadian Journal of Urology 2024, 31(1), 11784-11793.

Abstract

Introduction: Partial gland ablation (PGA) using high intensity focal ultrasound (HIFU) is an alternative to active surveillance for low to intermediate risk localized prostate cancer. This pilot study assessed quality of life (QoL) outcomes during the implementation of PGA HIFU at our institution.
Materials and methods: We prospectively enrolled 25 men with a diagnosis of localized low/intermediate risk prostate cancer who elected to undergo PGA-HIFU in a pilot study at our institution between 2013 and 2016. Patients underwent pre-treatment mpMRI and transrectal ultrasound-guided biopsies. The primary endpoints were impact on patient-reported functional outcomes (erectile, urinary function, QoL) assessed at 1, 3, 6- and 12-months.
Results: The median age was 64 years old (IQR 59.5 67). Baseline median International Index of Erectile Function-15 score was 50, which decreased to 18 at 1 month (p < 0.0005), returned to baseline by 3 months and thereafter. International Prostate Symptom Score median at baseline was 8, which worsened to 12 at 1 month (p = 0.0088), and subsequently improved to baseline thereafter. On the UCLA-Expanded Prostate Cancer Index Composite urinary function, there was a decrease in median score from 92.7 at baseline to 76.0 at 1 month (p < 0.0001), which improved to or above baseline afterwards. QoL remained similar to baseline at each follow up period as assessed by EQ-5D and the Functional Cancer Therapy-Prostate score.
Conclusions: In this initial cohort of PGA-HIFU men at our institution, patients demonstrated a slight, but transient, deterioration in urinary and erectile function at 1 month prior to normalization. All QoL metrics showed no impact upon 1 year of follow up post-treatment.

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