Tumours of prostate gland and urinary bladder cancers are the most frequent diseases in oncourology. Last decades their noticeable increase is observed. For many patients with hormone-resistant and insensitive to radial therapy prostate cancers with high risk of radical surgical treatment, with advanced bladder cancers, new methods of treatment is searched. One of them, the most efficient for treatment of the specified diseases is the cryosurgery.

Allows to guarantee destruction of tumoral locus

High effectiveness of this method is unconditionally determined by technical opportunities of instrumentation. Cryosurgical “Cryo-Pulse” unit was used for our purposes.

The potent cooling capacity and nitric temperature (up to minus 180°С) in contact with biological tissue allows to achieve effective regimens of treatment and considerably reduce possible occurrence of relapses, i.e. to guarantee destruction of tumoral locus. The method soft, flexible and also can be successfully applied in difficult cases. Namely in patients with an oestrogenic resistance in acute or chronic ischuria, after unefficient irradiation, and with life-long suprapubic urocystic fistula.

In prostate adenoma, this method is used in elderly patients with serious complications of underlying disease. In such patients, the high and highest degree of operational risk does not allow to make radical surgical treatment.

In bladder cancer, cryosurgery is shown in patients with tumours on Т1-3 stages and recurrent neoplasm as ablastics factor in combined treatment including intensive preoperative irradiation and radical surgery as well as independent method in tumours in the area of urinary bladder neck where the resection is technically difficult and not always can be executed radically, and in cancer on ТЗ stage, particularly on Т4 and relapses where the radical surgical intervention is impracticable.

In prostate tumours, operation can be carried out under direct vision in patients with urinary bladder dissected for the first time or under digital control of patients with lifelong cystosome.

The state of patients in the proximate postoperative period depends, as a rule, on initial condition, that is from general state of the patient in preoperative period.

After cryotherapy, patients have suprapubic urocystic drainage for 1,5-2 months up to complete rejection tissues subjected to freezing, then drainage is removed and fistula is healed.

Cryosurgical treatment in bladder cancer with tumour localized in cervical area is radical method, easily accessible in events where the routine surgical intervention is impossible. In operable tumours of bladder with other localization, suboperational freezing with subsequent excision of hardened neoplasm is the most efficient ablastics factor, essentially reducing recurrence. In bladder cancer, cryosurgery is the method of choice and the only method not only in medical, but also in social rehabilitation of a major group of patients.

Ivan Aleksandrovich KLIMENKO
Doctor of Medicine
The Head of Oncourologic Department,
Ukrainian Scientific and Research Institute
of Urinology and Nephrology