History of 3+4 adenocarcinoma in the left lateral apex. Patient used prophylactic antibiotics before and after the procedure asprescribed. The patient received antibiotic prophylaxis with oral Ciprofloxacin 500 mg bidstarting the night before the procedure. He took 2 tablets of Ciprofloxacin 500 mg beforethe procedure and will take two tablets after the procedure. Following the discussion ofthe risks, benefits, and alternatives of the procedure with the patient, informed consent was obtained forthe procedure. The procedure was performed under moderate conscious sedation.MRI focus in the left apex peripheral zone suspicious for patient's known cancer waslocalized with T2 weighted MR images. Following sterile preparation, Visualase laserablation template was placed on the patient's perineum and localized on MR images andregistered to the MR images where prostate lesion could be visualized.Following local anesthesia with lidocaine, 14-gauge MR- compatible needles were insertedinto the left side of the prostate. Upon confirmation of the tip of the needle on theside close to the known lesion, laser ablation in the left apex was performed with15-W, 90 % power. This was repeated several times to adequately ablate the left apex peripheral zone. The patient tolerated the procedure well without any immediate complications.Pre-and postcontrast axial MR images are obtained before and after administration of 14 ccMultiHance, upon completion of the procedure. On MR images of ablation defect was notedwithin and around the apical peripheral zone.COMPLICATIONS: None.
Successful MR guided laser ablation of the left apex of the prostate.PLAN: The patient returned to the post-procedure area for monitoring. The patient will be discharged once he voids. If the patient is unable to void a Foley Catheter will be placed and the patient will follow-up with the Urology service. 