Feedback microwave thermotherapy with the ProstaLund Compact Device for obstructive benign prostatic hyperplasia: 12-month response rates and complications.
OBJECTIVE
To evaluate the effectiveness of the ProstaLund Compact Device in the treatment of benign prostatic hyperplasia (BPH).


METHODS
A series of 38 consecutive patients with a mean age of 72.6+/-8.2 years, 19 with an indwelling catheter, underwent transurethral microwave thermotherapy (TUMT) with the ProstaLund Compact Device. Pretreatment evaluation included transrectal ultrasonography (TRUS), urodynamics, and cystoscopy for all patients and flow rate (Qmax), postvoiding residual urine volume (PVR), International Prostate Symptom Score (IPSS), and quality-of-life (QoL) assessment for those without a catheter. The mean prostate volume was 63.5+/-30 cc. The Qmax, IPSS, and QoL studies were repeated at 3, 6, and 12 months, while urodynamics, cystoscopy, and TRUS were repeated at 6 and 12 months.


RESULTS
The treatment lasted a mean of 43.1+/-17.1 minutes, achieved a maximal intraprostatic temperature of 58.7+/-7.2 degrees C, and destroyed 18.4+/-14.3 g of prostatic tissue. Twelve months post-treatment, for the patients without a catheter preoperatively, the IPSS was improved from 21.5+/-6.3 to 6.5+/-3.1 (P<0.001), Qmax from 7.2+/-3.1 mL/sec to 18.1+/-7.4 mL/sec (P<0.001), detrusor pressure at Qmax from 87.5+/-15 cm H2O to 48.4+/-16.4 cm H2O (P<0.001), and PVR from 113.2+/-78.2 mL to 34.6+/-36.7 mL (P<0.01). The good-response rates for IPSS (<or=7 or >or=50% improvement), Qmax (>or=15 mL/sec or >or=50% improvement), PVR (<50 mL or >or=50% decrease), and QoL (<or=2) were 73.7%, 84.2%, 73.7%, and 94.7%, respectively. For the patients with a catheter preoperatively, the IPSS improved from 9.5+/-6 at 3 months to 5.1+/-5.3 (P<0.05) at the end of the follow-up period. The Qmax was 13.2+/-6.4 mL/sec at 3 months and remained stable throughout the follow-up period. Patient good-response rates for IPSS (<or=7), PVR (<150 mL), and QoL (<or=2) were 75%, 87.5% and 75%, respectively. Only two patients were unable to void after the treatment. Complications were similar to those presented in the literature, and bladder stone formation was noted as well (five patients).


CONCLUSIONS
ProstaLund thermotherapy is a highly promising alternative treatment for BPH, improving substantially both objective and subjective measures of bladder outflow obstruction.
Alivizatos
G
G
2nd Urology Department, Athens Medical School, Sismanoglion Hospital, Athens, Greece. gali@hol.gr
Ferakis
N
N
Mitropoulos
D
D
Skolarikos
A
A
Livadas
K
K
Kastriotis
I
I
D000368:Aged; D000369:Aged, 80 and over; D002408:Catheters, Indwelling; D003558:Cystoscopy; D019160:Endosonography; D004867:Equipment Design; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D011470:Prostatic Hyperplasia / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D012189:Retrospective Studies; D020728:Transurethral Resection of Prostate / Q000295:instrumentation*; D016896:Treatment Outcome; D014546:Urinary Catheterization / Q000295:instrumentation; D016055:Urinary Retention / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D014563:Urodynamics / Q000502:physiology