In preparation for the HIFU procedure, your urologist will recommend an Enema at least 2 hours before the procedure or the night before so that the rectal cavity is completely clear. If constipation occurs, the patient may also take a bottle of magnesium citrate which is prescribed by a doctor. It is also suggested that the patient take prophylactic antibiotics at 3 days before the procedure is to take place.
Minimal anesthesia is required to ensure that the patient stays completely still during the procedure. Upon arrival, the anesthesiologist will decide which type of anesthesia to use. Once the patient has been anesthetized, the procedure will begin with the insertion of a catheter into the penis. The type of catheter will be discussed with the doctor before the procedure begins.
The amount of lesions that need to be placed to achieve full treatment is determined by measuring the prostate in three different dimensions. Next, the surgeon will begin the procedure in zones. Each zone will consist of several lesions, and each lesion is about the size of a grain of rice. Treatment is over once each zone has been successfully ablated. The time it takes for this procedure can take between 1 and 4 hours depending on whether some or the whole gland is being treated.
While the physician treats the targeted zones, he or she is also looking at the color of the tissue to make sure it is changing. The change in the color of the tissue assures that the zone has been properly ablated, and they can move on to the next zone. If the color does not change, a second pass may be required. For patients who are undergoing nerve sparing, close monitoring and any necessary maintenance of blood flow will assure maintenance of sexual function.
Once all zones have been properly ablated, you will be placed in a recovery room for about an hour until you wake up. The catheter will continue to stay in place over the next few days to assist with any urinary issues that may ensue. You will go home the same day your procedure is done, and you can return to normal activities within 1-2 days. Antibiotics may be prescribed to the patient to prevent a urinary tract infection, and Flomax or a similar drug may be prescribed in order to prevent voiding from happening upon removal of the catheter. Once the catheter is removed, patients may experience urinary frequency among other symptoms. If you have any other questions or concerns, feel free to contact our nurse in our call center.
It is crucial that after receiving HIFU, one does not undergo any other surgeries such Transurethral resection of the prostate (TURP) without consulting their doctor. The proper order is to get a laser or TURP before HIFU if you are having urinary symptoms as a result of prostate enlargement. If urinary problems are developed after HIFU it is more beneficial to treat it by leaving the catheter in place for an extended period of time to allow the healing process run its course. Rushing into another surgery too soon after HIFU could end up causing more incontinence.
Due to the catheter being in place, there is a slight chance that a urinary tract infection could be contracted; thus patients will be required to take antibiotics. Spasms can sometimes occur after treatment, so patients may also receive a muscle relaxing prescription for that as well. In terms of pelvic cramp alleviation, taking a warm bath can reduce the pain. Flomax may also be prescribed a few days before removal of the catheter to assist with voiding. In most cases, pain medications are unnecessary after treatment.