High-energy transurethral microwave thermotherapy: a thermoablative treatment for benign prostatic obstruction.
OBJECTIVE
High-energy transurethral microwave thermotherapy (TUMT) was developed to increase treatment efficacy over former low-energy treatment protocols as an outpatient-based, anesthesia-free procedure for patients with benign prostatic obstruction. A Phase II study was conducted to evaluate treatment outcome and to enlighten possible prognostic factors.


METHODS
Eighty-five patients with lower urinary tract symptoms were included in the study. A Madsen symptom score of 8 or more, a maximum flow less than 15 mL/s, and a postvoid residual urine volume (PVR) of under 350 mL were the main requirements for entry.


RESULTS
Eleven patients were lost to follow-up, making 74 patients evaluable at 1-year follow-up. Significant improvement was noticed in all indices: the Madsen symptom score improved 58% from baseline; the maximum flow rate improved from 9.4 to 14.9 mL/s, with a decrease in PVR of 80 mL to 25 mL; bladder outlet obstruction could be relieved in 78% of patients; and prostate volume decreased by 20%, with cavity formation in 42% of patients. Patients with bigger prostates (greater than 40 cm3) and patients with more severe bladder-outlet obstruction appeared to be the best responders. Post-treatment morbidity consisted of a prolonged need for transurethral catheter drainage (mean 16 days), with correlated irritative voiding complaints for an average of 2 to 3 weeks.


CONCLUSIONS
Overall improvement of high-energy thermotherapy now shows comparable results to surgical resection of the prostate.
de Wildt
M J
MJ
Department of Urology, University Hospital Nijmegen, The Netherlands.
Debruyne
F M
FM
de la Rosette
J J
JJ
D000368:Aged; D000369:Aged, 80 and over; D003972:Diathermy / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D011470:Prostatic Hyperplasia / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D014463:Ultrasonography; D001748:Urinary Bladder Neck Obstruction / Q000503:physiopathology / Q000628:therapy*; D014563:Urodynamics