High-energy transurethral microwave thermotherapy for large severely obstructing prostates and the use of biodegradable stents to avoid catheterization after treatment.
OBJECTIVE
To assess the use of high-energy transurethral microwave thermotherapy (TUMT) for large severely obstructing benign prostatic hyperplasia (BPH) and to compare the use of a biodegradable stent with that of a urethral Foley catheter after TUMT.


METHODS
The study comprised 30 men (mean age 71 years, range 49-82) scheduled for prostatectomy for symptomatic BPH. Pre-operative investigations included the measurement of urinary free flow rate, residual urine volume (ultrasonographically), a digital rectal examination, transrectal ultrasonography, a symptom score, cystoscopy, cystometry and pressure-flow. The obstruction was graded according to the Schäfer nomogram. The patients were treated using the Prostatron (EDAP-Technorned, France) TUMT system; the software used provided a maximum power of 70 W. Patients were catheterised after treatment with either a Foley catheter or a biodegradable stent. After 3 months, the measurements and obstruction grading were repeated, and the effect of the stent assessed.


RESULTS
In the entire group, the mean (SD) free flow increased from 7.7 (2.4) to 14.0 (3.3) mL/s, the residual urine decreased from 125 (86) to 23 (25) mL and the symptom score decreased from 16 (8) to 5 (4). The mean (SD) degree of obstruction decreased from 81.0 (16) to 62.6 (15). The biodegradable stent completely avoided post-treatment retention.


CONCLUSIONS
High-energy TUMT can be used on large severely obstructing prostates with major subjective and objective improvements. The biodegradable stent is useful in relieving the problems of catheterization after treatment.
Dahlstrand
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Department of Urology, Sahlgrenska University Hospital, Göteborg, Sweden.
Grundtman
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Pettersson
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D000368:Aged; D000369:Aged, 80 and over; D001673:Biodegradation, Environmental; D002404:Catheterization; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D008297:Male; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D011470:Prostatic Hyperplasia / Q000628:therapy*; D015607:Stents; D016896:Treatment Outcome; D014546:Urinary Catheterization; D016055:Urinary Retention / Q000209:etiology / Q000628:therapy*; D014554:Urination