The evolution and state of modern technology for prostate cryosurgery

Prostate Cryoablation

“…The accumulation of solute, elevation of cellular pH, destabilization of cellular membranes, and mechanical sheering by ice formation lead to cell death when cryoablation is performed. Around tissue temperatures of 0 °C, the extracellular fl uid begins to crystalize [ 11 ]. This crystallization leads to an accumulation of solute within the remaining extracellular fl uid and induces osmotic shifts based on differential concentrations.…”

“…Modern systems use Argon as their freezing gas and helium as the warming gas. The gases used during cryoablation are under high pressure (3,000 psi) and as they circulate through the cryogenic probes, they are exposed to atmospheric pressure (15 psi) [ 11 ]. Due to the Joule-Thompson Effect, as argon enters the probes, it expands under the lower pressure causing the gas to cool.…”

“…Largely discarded until the 1980s, interest in prostate cryosurgery was renewed with several innovations [ 11 ]. The introduction of real-time monitoring with transrectal ultrasound allowed clinicians to control the ice ball generated and lower involvement of surrounding structures.…”

“…Finally, urethral preservation using a urethral warming catheter further lowered rates of urethral sloughing and incontinence post-procedure. An excellent review of these advancements with details can be found by Saliken and associates [ 11 ].…”

Cryoablation and cryolocalization in the management of breast disease

“…This innovation led to the investigation of cryoablation for different diseases, but cumbersome cryoprobes and a lack of control over the freezing process made widespread use impractical. The resurgence in interest in cryoablation results from the introduction of modern cryoprobes, which exploit the Joule-Thompson (J-T) effect [22]. The J-T effect predicts changes in temperature as gases expand through narrow ports from high to low pressure.…”