HIFU and erectile dysfunction risk is a discussion men need to have if they choose High Intensity Focused Ultrasound, or HIFU, as treatment for prostate cancer. HIFU is an emerging therapy that destroys tissue with rapid heat that is focused on the malignancy in the prostate gland.
HIFU is useful only when treating a single tumor or part of a larger tumor; it cannot treat prostate cancer that has spread. The procedure involves focusing sound waves on the prostate tumor, which heats the cancerous area and destroys tissues in the prostate without any damage to overlying or adjacent structures.
The entire procedure can take from one to three hours, and you need to have a urinary catheter in place for about two weeks following the procedure. Read More on HIFU for Prostate Cancer Treatment
HIFU has been used around the world to treat prostate cancer, although as of April 2013 it had not yet been approved by the FDA in the United States. However, clinical trials have been conducted and applications for approval of HIFU have been submitted to the FDA. In a small US safety trial, 91% of the participants had a negative biopsy six months after receiving HIFU treatment. HIFU is currently available to patients in locations close to the USA such as Bermuda and Mexico.
Elsewhere around the world, HIFU has been studied more extensively. A major problem with the majority of the studies, however, is that they have been uncontrolled. In a recent (September 2010) study published in European Urology, an investigative team conducted a systemic review of studies of HIFU from 2000 to 2010 that had included more than 50 participants. They evaluated 20 uncontrolled prospective studies with a total of 3,018 patients and discovered that the overall survival rates were 9% at 5 years and 83% at 8 years. By comparison, the biochemical disease-free survival rates at five years ranged from 45 to 84% and evidence on the effectiveness and safety of HIFU in men with prostate cancer is “of very low quality” and requires more research. HIFU and erectile dysfunction risk also needs to be considered. Read More on Side Effects of HIFU
HIFU and erectile dysfunction risk as well as other side effects has not been well researched. A study published in the Journal of Sexual Medicine offers some insight. Investigators found that 36 months after undergoing HIFU, 65.5% of men had regained erectile function, and there was no significant change in penis size when compared with before HIFU. (Li) Over a mean of 41 months, 20% of men in another study had urinary incontinence associated with HIFU and an erectile dysfunction rate of 77%. (Ripert) A review of HIFU and erectile dysfunction in another recent study found that it may occur in the range of 20 to 49.8% of men. (Mearini).
Li LY et al. Comparison of penile size and erectile function after high-intensity focused ultrasound and targeted cryoablation for localized prostate cancer: a prospective pilot study. J Sex Med 2010 Sep; 7(9): 3135-42
Mearini L, Porena M. Transrectal high-intensity focused ultrasound for the treatment of prostate cancer: past, present, and future. Indian J Urol 2010 Jan-Mar; 26(1): 4-11
Warmuth M et al. Systematic review of the efficacy and safety of high-intensity focused ultrasound for the primary and salvage treatment of prostate cancer. Eur Urol 2010 Sept 17