History of left-sided prostate cancer, with suspected enhancing correlate in the left anterior base of the prostate. Patient used prophylactic antibiotics before and after the procedure as prescribed. The patient received antibiotic prophylaxis with oral Ciprofloxacin 500 mg bid starting the night before the procedure. He took 2 tablets of Ciprofloxacin 500 mg before the procedure and will take two tablets after the procedure. In addition the patient took 2 tablets of Keflex 500 mg po the morning of the biopsy, 2 tablets right before the biopsy and will take 2 tablets the evening of the biopsy. Following the discussion of the risks (bleeding, infection, pain, soft tissue injury, incontinence, impotence), benefits, and alternatives of the procedure. Informed consent was obtained from the patient. The procedure was performed under moderate conscious sedation with nurse monitoring. The MRI focus in the left base suspicious for patient's known cancer was localized with T2 weighted MR images. Following sterile preparation, Visualase laser ablation template was placed on to the perineum of the patient and localized on MR images and registered to the MR images where the prostate lesion could be visualized.Following local anesthesia with lidocaine, 14-gauge MR- compatible needles were inserted into the left side of the prostate. Upon confirmation of the tip of the needle on the left side close to the known lesion, 9 laser ablations with 20-W, 90 % power were performed within the left anterior aspect of the prostate. The patient tolerated the procedure well without any immediate complications.Pre-and postcontrast axial MR images were obtained before and after administration of 16 ml of MultiHance, upon completion of the procedure. The non-enhancing ablation defect was noted within and around the left anterior aspect of the prostate.COMPLICATIONS: NoneBLOOD LOSS: 5 ml
MR guided laser ablation of the left anterior central gland of the prostate at the site of the previously described suspicious enhancing focus, felt to correspond to the patient's biopsy proven left-sided prostatic adenocarcinoma. PLAN: The patient was subsequently transferred to the recovery room for nurse monitoring. The patient will be discharged after voiding or with a Foley catheter. The patient will follow-up with urology. 