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HIFU Hemiablation, the best kept secret.
Now, you have to make sure you qualify HIFU. I recommend you take a second opinion check with another HIFU Dr., Perhaps Dr. Barkin in Toronto.
All the best
As Egb says, a good point to start is reading the HIFU experiences at this website. Generally speaking people seem to have had/be having reasonably positive experiences, although I seem to recall there is one man who had significant problems.
HIFU certainly works, and can frequently result in fewer problems of incontinence and ED. Although it has been around for about 10 years, there is still some uncertainty about its longer term oncological outcomes compared with surgery or brachytherapy. I think it's fair to say that both the technology and the expertise have improved considerably over the past few years, so I am quietly confident of its effectiveness and durability.
The main thing is to find a surgeon who has considerable experience with HIFU. As with any other form of treatment, having it done by someone with extensive experience gives you the best chance of a favourable outcome.
If you go to The Cancer Forums website (http://www.cancerforums.net/viewforum.php?f=5&sid=be63dae84a0781007440a9389fdfe366) you will find a sticky thread at the top dedicated to HIFU.
I agree that Toronto would likely be a good choice for HIFU if it's convenient. I believe it's the 'Maple Leaf Clinic'. A Toronto T.V. station did a very positive report on it in the past year on the nightly news. I gave it some consideration but elected to have the prostate removed.
I have heard and I have this problem is that HIFU can cause urethral strictures. Apparently, when the prostate is destroyed with the heating from the ultrasound, scar tissue is formed. For some reason that scar tissue will cause constriction of the urethral tube. Normally, scar tissue is designed to constrict to close a wound. In the urethra it may reduce the opening. In my case I had some constriction and the HIFU urologist dilated the urethra. A few months later the urethral stricture came back and he dilated again. This occurred a third time. I all cases after the dilation I was not cathetered and maybe that was the problem to keep the urethra open while it healed.
After the third time it closed up completely and I had to go to the emergency for catheterization. Unfortunately, the opening was too small and a catheter could not go through the stricture. The nurses tried several times and thought they had it in but when they started to inflat the bulb at the end of the catheter it was still in the urethra. This action stretched the urethra so the urine could flow again.
I discovered from my HIFU urologist that Sonablate 500 was starting to show up more of this problem and there was no explanation.
I had HIFU almost 2 years ago, I didn't have any troubles at all, a bit of a slow erection at first, but I have forgotten that.
The case of scar tissue in the urethra is because of the doctor, this is where experience counts. The gland itself is left as scar tissue and so that makes me wonder if there was cancer left...could it travel outside the gland, through hard scar tissue? doesn't seem likely to me, and so I am even more happy to have been told about HIFU.
I used Dr. Scionti of nyhifucenter.com and I haven't found anyone who doesn't rave about how he is the best. He's treated over 1,000 men in the course of 6 years and is always there to answer my questions.
