A prospective randomized trial of interstitial radiofrequency therapy versus transurethral resection for the treatment of benign prostatic hyperplasia.
OBJECTIVE
To carry out a prospective randomized trial comparing interstitial radiofrequency therapy (IRFT) with transurethral resection of the prostate (TURP) in the treatment of bladder outlet obstruction (BOO) caused by benign prostatic hyperplasia.


METHODS
The change in detrusor pressure at maximum flow (PdetQmax) was chosen as the primary measure of outcome but the symptom score, Qmax and residual volume were also measured. Patients with urodynamic evidence of BOO were randomized to receive IRFT (n = 25) or TURP (n = 25); the urodynamics were repeated 6 months after treatment.


RESULTS
There was a statistically significant reduction in PdetQmax at 6 months for TURP (P < 0.001) and IRFT (P < 0.01) although the change seen in the latter group was probably not clinically relevant. Nevertheless, a clinically relevant reduction in symptom score occurred in both groups. Both techniques were associated with a low morbidity.


CONCLUSIONS
IRFT is a cheap and safe technique which may be useful in the treatment of lower urinary tract symptoms in certain groups of patients in whom symptomatic improvement is a priority rather than objective outcome. The underlying mechanism for this symptomatic improvement is at present unclear.
Mostafid
A H
AH
Department of Urology, Brighton General Hospital, UK.
Harrison
N W
NW
Thomas
P J
PJ
Fletcher
M S
MS
D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods*; D011470:Prostatic Hyperplasia / Q000601:surgery*; D016896:Treatment Outcome; D001748:Urinary Bladder Neck Obstruction / Q000601:surgery