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HIFU (High Intensity Focused Ultrasound)HIFU is the newest and the least invasive of all of the alternatives to the radical prostatectomy. There are no cuts, no needles, and it can be done under a local spinal anesthesia. You can go out to diner the same day as the treatment. You can return to work a few days later. What is HIFU therapy?
There are two machines on the market today.EDAP makes the Ablatherm. This is a French company and has been doing HIFU for prostate cancer since 1995. The machine is limited to 30 gram prostates (relatively small prostates). It uses one of three standard power settings and the lesion created is 3mm X 3mm X 22mm. The probe is 50% larger than the Sonoblate 500. There is very little user input once the machine is turned on (set it and forget it). Often a TURP (surgical removal of the inside of the prostate or “roto-rooter”) is performed before the HIFU procedure to make the prostate small enough to do the Ablatherm procedure. Cure rate is 90% for early prostate cancers with PSA less than 10 and Gleason score 6. For more advanced cancers with a palpable nodule and with PSA of 20 or less and Gleason score 7 or more the cure rate is 80%. This is similar to other forms of treatment such as radical prostatectomy, radiation therapy, or cryoablation. The PSA should drop to 0.2 after a successful treatment. Incontinence is minimal and potency is 50%. Treatment takes 2 to 3 hours to perform.
HIFU machines are being clinically tested by the FDA in the United States at present. HIFU should be available in the USA in 2011 or 2012. International HIFU based in Charlotte North Carolina is the exclusive distributor for the Sonoblate 500 in North America, Central America and South America. Presently the procedure is currently being done under the direction of International HIFU in Toronto, Niagara Falls, Montreal, Nassau, Cancun, and Puerto Vallarta. The site in Toronto is run by Urologists from the medical school. The cost is $25,000. The procedure will not be covered by US insurance until it gets FDA approval. For further information visit these websites www.ushifu.com or www.internationalhifu.com or www.focus-surgery.com. The Ablatherm machine is currently available in Toronto.Home | Administration | Locations: Urology Specialists of West Florida 1 in Clearwater, Bardmoor, Palm Harbor | Urology Specialists of West Florida 2 - Urology Consultants in Safety Harbor, Trinity, Tampa | Urology Specialists of West Florida 3 in New Port Richey, Tampa, Trinity, Palm Harbor | Urology Specialists of West Florida 4 - Pinellas Urology in St. Petersburg | Urology Specialists of West Florida Radiation Oncology Center in Clearwater | Our Doctors | Patient Education for Urology Conditions | Post-Operative Instructions for Urology Patients | Latest Technology for Urological Conditions | Urology Specialists of West Florida In the News Disclaimer: The pictures displayed in www.UrologySpecialistsFlorida.com are images of physicians, patients and employees who have consented to have their pictures in this website.
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There are many tools available to urologists including cystoscopy, ultrasound scanning to image the prostate and bladder, urodynamic testing to evaluate the cause of urinary problems and urinalysis. Click here to learn more about the new innovations in Urology Oncology.  Urology places special emphasis on the urinary tracts of males and females as well as the reproductive system of males. Often, urology problems and disorders show many different signs and symptoms and many urology diseases and disorders have similar symptoms. Read more.
Our physicians put particular emphasis on the urinary tracts of males and females, as well as the reproductive system of males, and their primary focus is to diagnose, treat, and control urological disorders. Read more.
We understand the health problems and concerns specific to men. It is important to detect male health problems early and to modify lifestyles to live longer. Read more.
Women of all ages can have urological problems. From bladder problems to kidney disorders, to urinary tract infections, we devote a great deal of time and energy to investigating and treating these urological problems and others. Read more.
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High intensity focused ultrasound uses ultrasound energy precisely focused to rapidly heat tissue to 100 degrees Celsius for 2-3 seconds, effectively destroying tissue. Similar to what happens when sunlight is focused through a magnifying lens, precise focusing of ultrasound energy elevates the temperature of the tissue in the focal zone very rapidly while intervening tissue is kept at a safe temperature. The difference is that instead of light as an energy source ultrasound is used, and instead of a magnifying lens to focus the energy an ultrasound transducer is used. The imaging capabilities of the technology allow for identification and preservation of vital structures such as the neurovascular bundles that contain the nerves and arteries vital to maintaining erections. Also the apex of the prostate and the external sphincter can be easily seen and identified, thus avoiding the sphincter muscles that might damage continence.
Focus Surgery makes the Sonablate 500 in Indianapolis. The current machine has been in clinical use since 2001. It has two focal length probes, 3 cm and either a 4 or a 5 cm probe. The HIFU lesion created is 3mm X 3mm X 9mm in size and is smaller (i.e., more precise) than the lesion created by the Ablatherm machine. It can treat glands up to 40 or 50 grams in size (small to moderate in size). Because the lesion produced is small and because the urologist is actively adjusting the machine during the entire procedure, the nerves and the sphincter muscles can be accurately identified and preserved. This is time consuming and treatment generally takes 2 to 4 hours to perform. Incontinence is 0.6% and impotence can be as low as 10% with nerve sparing techniques (20% figures are standard in the literature). The 4 year PSA cure rate is 94% (Uchida et al, British J Urology, 2006) with early cancers. 92% of men get a PSA of 0.2 ng/mL or lower three months after treatment. Worldwide over 6,000 treatments have been done with the Sonablate 500 as of 2009. Who is a candidate? Anyone with a PSA less than 15 and a prostate less than 50 grams with a height of 4 ½ cm or less is a candidate for HIFU. If you are interested in HIFU treatment for prostate cancer contact your urologist and have your Gleason’s score, biopsy report, PSA, prostate size in grams, and the height of the prostate in centimeters available when you call.
