Table 6.
Perioperative and functional outcome of patients undergoing focal therapy in the primary setting
| Reference | Length of stay, d, median | Anaesthesia | Complications, actual (%) | Urinary continence, actual (%) | Erectile function*, actual (%) | Rectal toxicity, actual (%) | Quality of life | Trifecta outcome**, actual (%) |
|---|---|---|---|---|---|---|---|---|
| Madersbacher et al. [15] | NR | General | NR | NR | NR | NR | NR | NR |
| Zlotta et al. [16] | NR | General or spinal | NR | NR | NR | NR | NR | NR |
| Beerlage et al. [17] | 2 | General or spinal | NR | NR | NR | Rectourethral fistula: 0/14 (0) Perineal pain: 14/14 (100) Rectal bleeding: NR Diarrhoea: NR PROM: NR |
NR | NR |
| Souchon et al. [18] | NR | NR | NR | NR | NR | NR | NR | NR |
| Moore et al. [19] | 1 | General | Urinary retention: 1/6 (17) Urethral stricture: NR UTI: 1/6 (17) Outcome measure: NR |
Pad free: NR Leak free: 5/6 (83) PROM: AUA-7 |
1/3 (33) PROM: Brief Sexual Function Inventory |
Rectourethral fistula: 0/3 (0) Perineal pain: NR Rectal bleeding: 2/6 (33) Diarrhoea: 2/6 (33) PROM: NR |
NR | NR |
| Bahn et al. [20] | NR | NR | NR | Pad free: 28/28 (100) Leak free: NR PROM: NR |
24/27 (88.8) PROM: Brief Male Sexual Function Index |
NR | NR | NR |
| Onik et al. [21] | NR | NR | NR | Pad free: 24/25 (96) Leak free: NR PROM: NR |
44/51 (85) PROM: NR |
NR | NR | NR |
| Ellis et al. [22] | 1 | NR | NR | Pad free: 55/55 (100) Leak free: 53/55 (96.4) PROM: NR |
24/34 (70.6) PROM: NR (vacuum therapy and oral therapy for erectile dysfunction offered preoperatively) |
Rectourethral fistula: 0/34 (0) Perineal pain: NR Rectal bleeding: NR Diarrhoea: NR PROM: NR |
NR | NR |
| Muto et al. [23] | 1 | NR | Urinary retention: NR Urethral stricture 1/25 (4) UTI 1/25(4) Outcome measure: NR |
Pad free: NR Leak free: NR PROM: UCLA-EPIC, IPSS |
NR | NR | NR | NR |
| Murat et al. [24] | NR | NR | NR | NR | 28/52 (54) PROM: IIEF-5 |
NR | NR | NR |
| Lindner et al. [25] | 1 | General | Urinary retention: 0/12 (0) Urethral stricture: 0/12 (0) UTI: 0/12 (0) Outcome measure: NR |
Pad free: 12/12 (100) Leak free: 12/12 (100) PROM: IPSS |
NR (100) PROM: IIEF-5 |
Rectourethral fistula: 0/12 (0) Perineal pain: 3/12 (25) Rectal bleeding: 0/12 (0) Diarrhoea: 0/12 (0) PROM: NR |
NR | 6/12 (50) |
| Lindner et al. [26] | NR | NR | NR | NR | NR | NR | NR | NR |
| Raz et al. [27] | 1 | General | NR | NR | NR | NR | NR | NR |
| Truesdale et al. [28] | 1 | General or spinal | NR | Pad free: 77/77 (100) Leak free: NR PROM: IPSS |
NR PROM: IIEF |
NR | NR | NR |
| El Fegoun et al. [29] | NR | NR | Urinary retention: 1/12 (8) Urinary stricture: 0/12 (0) UTI: 2/12 (16) Outcome measure: NR |
Pad free: 12/12 (100) Leak free: NR PROM: IPSS |
NR | NR | NR | NR |
| Ahmed et al. [30] | 1 day | General | Urinary retention: 0/20 (0) Urinary stricture: 1/20 (5) UTI: 0/20 (05) Outcome measure: NR |
Pad free: 19/20 (95) Leak free: 18/20 (90) PROM: UCLA-EPIC, IPSS |
19/20 (95) PROM: IIEF-15 |
Rectourethral fistula: 0/20 (0) Perineal pain: NR Rectal bleeding: NR Diarrhoea: NR PROM: FACT-P |
No significant difference between baseline and last follow-up PROM: FACT-P, FACT-G |
17/19 (89) |
| Ward et al. [31] | NR | NR | Urinary retention: 6/518 (1.1) Urinary stricture: NR UTI: NR Outcome measure: NR |
Pad free: 499/507 (98.4) Leak free: NR PROM: NR |
169/291 (58.1) PROM: NR |
Rectourethral fistula: 1/507 (0.1) Perineal pain: NR Rectal bleeding: NR Diarrhoea: NR PROM: NR |
NR | NR |
| Tay et al. [32] | NR | NR | NR | NR | NR | NR | NR | NR |
| Chopra et al. [33] | NR | Spinal | NR | NR | NR | NR | NR | NR |
| Bahn et al. [34]† | 1 | NR | NR | Pad free: 73/73 (100) Leak free: NR PROM: NR |
36/42 (86) PROM: IIEF-5 |
Rectourethral fistula: 0/73 (0) Perineal pain: NR Rectal bleeding: NR Diarrhoea: NR PROM: NR |
NR | NR |
| Ahmed et al. [35] | 1 | General | Urinary retention: 1/41 (2.4) Urethral stricture: 0/41 (0) UTI: 0/41 (0) Outcome measure: NR |
Pad free: 40/40 (100) Leak free: 39/39 (100) PROM: UCLA-EPIC, IPSS |
31/35 (86) PROM: IIEF-15 |
Rectourethral fistula: suspicion in 1/41 (2.4) Perineal pain: NR Rectal bleeding: NR Diarrhoea: NR PROM: NR |
Significant small deterioration between baseline and last follow-up PROM: FACT-P, FACT-G |
26/31 (84) |
| Dickinson et al. [36]† | 1 | General | NR | Pad free: 86/87 (99) Leak free: 56/66 (85) PROM: IPSS, UCLA-EPIC |
76/85 (89) PROM: IIEF-15 |
Rectourethral fistula: 1/88 (1) Perineal pain: NR Rectal bleeding: NR Diarrhoea: NR PROM: NR |
Significant deterioration between baseline and last follow-up PROM: FACT-P |
NR |
| Nguyen et al. [37] | 1 | General | NR | NR | NR | NR | NR | NR |
| Napoli et al. [38] | 1 | NR | NR | NR | NR | NR | NR | NR |
| Barret et al. [39] | 1–2 | NR | Urinary retention: 9/106 (8) Urethral stricture: 1/106 (1) UTI: 0/106 (0) Outcome measure: Clavien-Dindo classification (13% complication rate, 2% major) |
Pad free: 106/106 (100) Leak free: NR PROM: IPSS |
NR PROM: IIEF-5 |
Rectourethral fistula: 1/106 (1) Perineal pain: 1/106 (1) Rectal bleeding: 0 Diarrhoea: NR PROM: NR |
NR | NR |
NR = not reported; PROM = patient-reported outcome measure; UTI = urinary tract infection; AUA-7 = American Urological Association symptom index 7; UCLA-EPIC = University of California, Los Angeles-Expanded Prostate Cancer Index Composite; IPSS = International Prostate Symptom Score; IIEF = International Index of Erectile Function; FACT-P = Functional Assessment of Cancer Therapy-Prostate; FACT-G = Functional Assessment of Cancer Therapy-General.
*
Ability to have penetrative intercourse.
**
Pad-free, leak-free continence; erections sufficient for penetration; absence of clinically significant disease after focal therapy.
†
This series partially overlaps with one previously reported.