HIFU COMPLICATIONS

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R4210
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Date Joined Aug 2008
Total Posts : 2
   Posted 8/7/2008 3:13 PM (GMT -6)   
I had a re-treatment of HIFU 4.25.08 and have a fistula as a result. I'm wondering if anyone has the same problem?

James C.
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   Posted 8/7/2008 3:53 PM (GMT -6)   
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MMMNAVY
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Date Joined Jul 2006
Total Posts : 6927
   Posted 8/8/2008 6:23 AM (GMT -6)   
I think you might want to see a gastroentrologist about the fistula, not all fistulas can be healed by a diet change. 
 
A fistula does not indicate crohns 90% of the time.  
 
You may want to have a colonscopy, just because it is a good idea after 50, but that is your GI doc's call.


Forum Co-moderator - Crohn's Disease
We will find a way, or make one.-Hannibal (crossing the Alps in the 15th Century on war elephants) 
Make sure your suffering has meaning...-?
All suggestions/options/opinions are caveated with please consult with your local health care provider...

Post Edited (MMMNAVY) : 8/8/2008 2:33:54 PM (GMT-6)


Guy66
Regular Member


Date Joined Jul 2008
Total Posts : 32
   Posted 8/8/2008 8:08 AM (GMT -6)   
Although HIFU is considered a minimally to non-invasive treatment, just like radiation therapy, there is a small risk to adjacent tissues, especially if the aim is even slightly off. This is a bigger risk with radiation, and fistulas are more common with radiation. My wife, a surgical RN sees this quite often. As we all know so well, the colon and rectum are in immediate contact with the prostate area, and it is possible that your colon received just enough heat to cause damage. However, as James pointed out, there are a number of other causes for fistulas. I made an appointment with my GI doc about two months after my surgery so that he could do a quick in office check and veryify everything was ok. You may have already been told all of this by your doc. I presume they told you what caused your fistula. Good luck!
Guy 66
first biopsy was in 1997. Neg. Dx BPH PSA 5.4
second biopsy in 2001 neg again PSA 9.8
passed blood Feb 08 3rd biopsy positive PSA 14.6 Gleason (3+3)=6
Pre op Xrays, CT scans, bone scans all neg
Da Vinci surgery 3/3/08 no complications, nodes clear
Significant post op discomfort for approx one week
Daily improvement 2nd week, near nornal mobility, etc 4th week
Filled pads every 2 hours for first month, gradually improved to not wearing pads after 2 months. Whoopee!
Occasional small leak when sneezing or farting, haha
Total loss of erectile function so far, some loss of rectal muscle function also.
Currently back to 100% physically, working out, etc.
Some lingering attitude issues over lack of function. Anger sometimes, moderate depression sometimes. Feel good physically but lingering changes in emotions. Joi da vie not the same. Feel lucky overall, but emotionally flat. A vague sense of loss, diminished pleasure in life. Hope to rebound as time goes by. Survived melanoma in 2000, pacemaker in 2002. Three time winner? Doesn't feel that way.


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 8/8/2008 8:39 AM (GMT -6)   

I think it is a far stretch and possibly damaging to automatically assume a person has crohns just because they describe a fistula.  There's lots of other causes, and there's lots of other descriptives that can be used, especially in a patient who has had HIFU.  chas036, I realize that you are a kinda crusader for dietary cures through other disease areas of Healing Well and that your wife had experienced  fistulas that were supposedly cured by diet alone, but to say that this guy has a 90% chance of crohns just from a few descriptive words is wrong, in my opinion. It would have been better to say to the poster that he needs to see his doctor, be examined and go from there, rather than throw possible fear of a really bad disease in him and offer a saves-all diet.    I would caution the original poster and others to not automatically assume fistulas are precursurs to crohns. 


James C.
Co-Moderator- Prostate Cancer Forum

Age 61
4/19/07 PSA 7.6, referred to Urologist, recheck 6.7
7/11/07 Biopsy- 16 core samples, size of gland around 76 cc. Staging pT2c
7/17/07 Path report: 3 of 16 PCa, 5% involved, left lobe , GS 3/3:6.
9/24/07 (open) Retropubic Radical Prostatectomy performed
9/26/07 Post-op Path Report: GS 3+3=6 Staging pT2c, 110gms, margins clear
10/15/07 ED- begin 50mg Viagra and Vacurect pump nightly, Fully continent
1/14/08 Caverject started/stopped, aching. 2/24/08 .5ml Bimix started-success
7/31/08 ED- Viagra, pump continues, no response- Trimix .10ml x 2 weekly continues
Post Surgery PSA's:  3 mts-0, 6 mts.-0, 9 mts.-0.

Post Edited (James C.) : 8/8/2008 10:44:58 AM (GMT-6)


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 8/8/2008 9:57 AM (GMT -6)   

Hi R4210,
While HIFU is largely performed in Europe, I have not read of too many occurances of fistula in that form of treatment.  But there are side effects to other forms of treatment including fistula easily searched on the web.  The most common is Cutaneous Fistula and Rectal-Urethra Fistula. Most commonly it is a result of brachytherapy or IMRT.  I have also found cases of it with cryoablation therapy. 

This is very rare and often inoperable.  But this needs to be reviewed by your doctors.  I doubt that diet will help from what I am reading, though it may make it less uncomfortable.  If you search "radiation" + "prostate" + "fistula" you will find many papers about these side effects.

Hyperbaric oxygen therapy is described as one possible treatment in the attached link

http://www.medicalnewstoday.com/articles/78523.php

I hope this helps.

Tony


Age 46 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007 @ The City of Hope
Post-Op Pathology: Gleason 4+3=7, positive margins, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 9 '08): <0.1
I will continue HT until May '09. 
Years in Remission (3/23/07): 1
Visit my Journey at:
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MMMNAVY
Veteran Member


Date Joined Jul 2006
Total Posts : 6927
   Posted 8/8/2008 11:41 AM (GMT -6)   
I just want to say there are options and it is definately not a forever thing.
Women get fistulas all the time from being pregant and giving birth, it is definately not only with crohns. 
So possible 90% of crohns patients get fistulas, but there is no way that 90 % of fistulas are from crohns.
They are very common and there is a mulitude of reasons for fistulas.

Guy66 is right on with this treatment can cause alot of trama for that delicate skin to handle, so that is why I said go see a doc.
They can determind what the best course of treatment. Minor surgery to antibodics are used to treat it. Some just do heal up on their own. But cancer and it's treatments are hard on the GI tract in general, so it is a good idea to check with a GI doc.
I am not a patient person, and so I used antibodics because I did not want to run the risk of infection. Plus running the risk of infection when you have cancer is a bad idea.


Forum Co-moderator - Crohn's Disease
We will find a way, or make one.-Hannibal (crossing the Alps in the 15th Century on war elephants) 
Make sure your suffering has meaning...-?
All suggestions/options/opinions are caveated with please consult with your local health care provider...

Post Edited (MMMNAVY) : 8/8/2008 2:19:07 PM (GMT-6)


Guy66
Regular Member


Date Joined Jul 2008
Total Posts : 32
   Posted 8/8/2008 1:03 PM (GMT -6)   
Yep, R4210 did not give us much info to go by. And Crohn's usually presents with many GI symptoms long before a fistula occurs. Your advice to see a doc before trying any home remedy was sound advice.
Guy 66
first biopsy was in 1997. Neg. Dx BPH PSA 5.4
second biopsy in 2001 neg again PSA 9.8
passed blood Feb 08 3rd biopsy positive PSA 14.6 Gleason (3+3)=6
Pre op Xrays, CT scans, bone scans all neg
Da Vinci surgery 3/3/08 no complications, nodes clear
Significant post op discomfort for approx one week
Daily improvement 2nd week, near nornal mobility, etc 4th week
Filled pads every 2 hours for first month, gradually improved to not wearing pads after 2 months. Whoopee!
Occasional small leak when sneezing or farting, haha
Total loss of erectile function so far, some loss of rectal muscle function also.
Currently back to 100% physically, working out, etc.
Some lingering attitude issues over lack of function. Anger sometimes, moderate depression sometimes. Feel good physically but lingering changes in emotions. Joi da vie not the same. Feel lucky overall, but emotionally flat. A vague sense of loss, diminished pleasure in life. Hope to rebound as time goes by. Survived melanoma in 2000, pacemaker in 2002. Three time winner? Doesn't feel that way.


R4210
New Member


Date Joined Aug 2008
Total Posts : 2
   Posted 8/8/2008 3:31 PM (GMT -6)   
Thanks for all the input..I have a rectal-urethral fistula in exactly the area where I was treated with HIFU. I don't have Crohn's or an infection or an abcess. There's almost no doubt in my doctor's minds that this fistula was caused by the treatment. I'm looking for anyone who has the same problem...

Guy66
Regular Member


Date Joined Jul 2008
Total Posts : 32
   Posted 8/8/2008 7:57 PM (GMT -6)   
I kinda thought you had got the word from your doc. My wife tells me that patients at her hospital with fistulas often have the same kind of surgery that is done to repair a rectal fissure. Although I was a bit of an "assman" in my younger days (pardon the Sienfeld show joke) I don't claim to have any personal expertise about this subject. You may want to search under GI and similar sites as the corrective procedures should be very similar.
Guy 66
first biopsy was in 1997. Neg. Dx BPH PSA 5.4
second biopsy in 2001 neg again PSA 9.8
passed blood Feb 08 3rd biopsy positive PSA 14.6 Gleason (3+3)=6
Pre op Xrays, CT scans, bone scans all neg
Da Vinci surgery 3/3/08 no complications, nodes clear
Significant post op discomfort for approx one week
Daily improvement 2nd week, near nornal mobility, etc 4th week
Filled pads every 2 hours for first month, gradually improved to not wearing pads after 2 months. Whoopee!
Occasional small leak when sneezing or farting, haha
Total loss of erectile function so far, some loss of rectal muscle function also.
Currently back to 100% physically, working out, etc.
Some lingering attitude issues over lack of function. Anger sometimes, moderate depression sometimes. Feel good physically but lingering changes in emotions. Joi da vie not the same. Feel lucky overall, but emotionally flat. A vague sense of loss, diminished pleasure in life. Hope to rebound as time goes by. Survived melanoma in 2000, pacemaker in 2002. Three time winner? Doesn't feel that way.

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