Is there a role for transrectal microwave hyperthermia in the treatment of benign prostatic hyperplasia? A critical review of a six-year experience.
We critically reviewed our 6-year experience with transrectal microwave hyperthermia of the prostate for benign prostatic hyperplasia (BPH) in 320 patients either at high surgical risk or refusing surgery. Transrectal prostatic hyperthermia was given in five to ten 60-minute sessions with an intraprostatic temperature ranging from 42 degrees to 43.5 degrees C. Although an amelioration of symptoms and urodynamic measures was seen initially in most patients, only residual urine volume showed a statistically and clinically significant improvement at the long-term follow-up. According to maximum flow nomograms, bladder outlet obstruction was not resolved by the treatment. We conclude that although the transrectal hyperthermia proved to be a safe procedure, it did not cure BPH in the long term. Considering the results seen with newer nonsurgical procedures such as prostatic stents and prostatic lasers, we believe that transrectal hyperthermia should not be recommended to symptomatic BPH patients.
Montorsi
F
F
Institute of Human Anatomy, University of Milan School of Medicine, Italy.
Guazzoni
G
G
Rigatti
P
P
Pizzini
G
G
Miani
A
A
D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced; D008297:Male; D008872:Microwaves; D008875:Middle Aged; D011184:Postoperative Period; D011300:Preoperative Care; D011470:Prostatic Hyperplasia / Q000628:therapy*; D012007:Rectum; D012189:Retrospective Studies; D012307:Risk Factors; D001748:Urinary Bladder Neck Obstruction / Q000628:therapy*