History of multifocal prostate cancer. Patient presents for focal laser ablation of the 3+3 cancer in the left side of the prostate 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, informed consent was obtained forthe research study. The procedure was performed under moderate conscious sedation.MRI focus in the left base, mid-gland and apical peripheral zone suspicious for patient's known cancer waslocalized with T2 weighted MR images. Following sterile preparation, Medtronic's laserablation template was placed in the perineum on the patient 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 to stabilize the prostate. Upon confirmation of thetip of the needle on the left side close to the known lesion, a total of5 laser ablationswith 30-W, 90 % power was performed within the left mid-gland and apical peripheral zone of theprostate zone. The patient tolerated the procedure well without any immediate complications.Pre-and postcontrast axial MR images are obtained before and after administration of 20 ccMultiHance, upon completion of the procedure. On MR images of ablation defect was notedwithin and around the ablated region. COMPLICATIONS: No immediate complications.BLOOD LOSS: < 10 ml
MR guided laser ablation of the left base mid-gland and apical peripheral zone of theprostate.PLAN: Patient was sent to the post-procedural area for observation to ensure voiding. Will follow-up with urology.