30 minutes high energy transurethral microwave thermotherapy (30 minutes TUMT) for the treatment of chronic urinary retention in patients with ASA II-III-IV.
OBJECTIVE
To investigate if 30-Minutes-TUMT was useful and safe in the treatment of chronic urinary retention due to BOO in patients with ASA II-III-IV.


METHODS
19 patients with chronic urinary retention (mean age 73.5 years) were scheduled for TUMT treatment because of absolute or relative contraindications to surgery. According to ASA classification there were 8 patients ASA II, 9 ASA III and 2 ASA IV. Routinely parameters were studied before and after treatment. Pain and patient's discomfort before, during and after TUMT treatment were registered using the VAS score (visual analogue scale: 0 = no pain and 10 = maximal pain). Urgency, irritation, and "how they feel" were registered at 2 days, 1, 2 and 4 weeks after TUMT using VAS technique.


RESULTS
Mean follow-up was 31,6 months (range 24-47), among the 9 responders patients (47.4%) who void normally without need of catheterisation, one patient died 12 months after the treatment for reasons not connected to the TUMT. Six patients (21.6%) failed the treatment and underwent TURP one or two years later (5 were ASA II and one ASA III). Among the 4 of 19 (21.0%) who had intermittent catheterisation after the treatment two died 1 and 2 years later, one has detrusor instability and one continued intermittent catheterisation. VAS during treatment was: 0 minute = 0.0; 5' = 3.1; 15' = 2.9; 25' = 2.8; 2 h after the treatment = 0.3. At 3 years follow up IPSS, QoL and Qmax were still acceptable. No major complication occurred.


CONCLUSIONS
47.4% of the patients responded positively to the new 30 minutes TUMT removing the urethral catheter, without needing surgical procedure avoiding the operation risk. 68.4% also improved their QoL. Local anaesthesia and oral/intravenous analgesia were sufficient during treatment. TUMT seems to have no anesthesiological risk. It is an option in patients with high risk of operation.
Department of Urology, Sahlgrenska University Hospital, Göteborg, Sweden. dicuiomauro@hotmail.com
Mauro
M
Dicuio
Stepan
S
Vesely
Tomas
T
Knutson
Jan-Erik
JE
Damber
Diego Ettore
DE
Cuzzocrea
Christer
C
Dahlstrand
D000368:Aged; D000369:Aged, 80 and over; D003972:Diathermy / Q000379:methods; D006801:Humans; D008297:Male; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D011446:Prospective Studies; D053448:Prostatism / Q000150:complications; D013997:Time Factors; D001748:Urinary Bladder Neck Obstruction / Q000209:etiology / Q000628:therapy*; D016055:Urinary Retention / Q000209:etiology / Q000628:therapy*