This group-wise comparison was designed to elucidate the impact of the learning curve and technologic transit, and to compare the two modalities in terms of morbidity profile as salvage treatments for RRPC, without inter-operator and inter-institutional variability.
(19) Given the reasonable oncologic outcome in the management of RRPC with these modalities, minimizing treatment-related morbidity becomes more of a clinical priority.
Crouzet and colleagues reported a 19.5% incontinence rate in 290 patients treated with HIFU for RRPC. (19) This difference may be attributed to different definitions of incontinence, variations in surgical technique or technology (Ablatherm HIFU [Maple Leaf Inc.] or Sonablate HIFU), and in patient selection.
Recto-urethral fistula is the most serious complication in the local salvage treatment of RRPC. We report an incidence of 1.5% to 3% in the 3 groups.
With the advances in magnetic resonance imaging technology, it is now possible to delineate the focus of RRPC and we believe that focal salvage may be a viable treatment option for selected potent men with RRPC.