The 2-year symptomatic and urodynamic results of a prospective randomized trial of interstitial radiofrequency therapy vs transurethral resection of the prostate.
OBJECTIVE
To assess the 2-year symptomatic and urodynamic results of a prospective randomized trial of interstitial radiofrequency therapy of the prostate (IRFT) vs transurethral resection of the prostate (TURP).


METHODS
Patients with lower urinary tract symptoms (LUTS) and urodynamic evidence of bladder outlet obstruction (BOO) were randomized to undergo IRFT or TURP and were followed up using the International Prostate Symptom Score (IPSS) and urodynamic assessment for 2 years.


RESULTS
At 2 years there was a clinically relevant reduction in the IPSS in the IRFT (20 to 9) and TURP groups (22 to 4). There was also a statistically significant reduction in the detrusor pressure at maximum urinary flow in both groups, but the reduction in the IRFT group was probably not sufficient to explain the observed symptomatic improvements solely from a reduction in BOO.


CONCLUSIONS
IRFT can produce a sustained improvement in LUTS for at least 2 years. However, such improvements are unlikely to be entirely the result of a reduction in BOO. The effects of radiofrequency energy may, at least partly, be independent of any thermal effect and depend instead on neuromodulation of lower urinary tract nerves.
Hindley
R G
RG
Department of Urology, Royal Sussex County Hospital, Brighton, East Sussex, UK. richard.hindley@virgin.net
Mostafid
A H
AH
Brierly
R D
RD
Harrison
N W
NW
Thomas
P J
PJ
Fletcher
M S
MS
D017115:Catheter Ablation / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D011788:Quality of Life; D020728:Transurethral Resection of Prostate / Q000379:methods*; D016896:Treatment Outcome; D014563:Urodynamics; D014570:Urologic Diseases / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*