title: High energy microwave thermotherapy for symptomatic benign prostatic enlargment: predictive parameters of long term outcome.
abstract: OBJECTIVE
  High-energy transurethral microwave thermotherapy (HE-TUMT) has become one of the most preferred minimally invasive procedure for the treatment of benign prostatic enlargement (BPE). In this study we report the long term results in a subset of patients treated with the 30-minute high energy protocol.
  
  
  METHODS
  A total of 135 patients were treated with TUMT Prostasoft 3.5. The International Prostate Symptom Score (IPSS), Madsen Symptom Score (MSS), Quality of Life (QoL) score, peak urinary flow rate (Qmax) and post-voiding residual urine volume (PVR) were assessed at baseline and at 12, 24, 36, 48 and 60 months after treatment.
  
  
  RESULTS
  The mean follow-up period was 46.1 months. The mean IPSS at baseline was 17.8 and decreased to 5.6 at 60 months (p < 0.001). The MSS decreased from 12.6 at baseline to 4.3 at 5 years (p < 0.0001). The QoL score improved from 4.1 to 2.2 at 5 years (p < 0.001). The mean Qmax value at baseline was 9.4 ml/sec and it improved to 15.7 ml/sec at 60 months (p = 0.001), whereas PVR decreased from 97 to 24 ml at 5 years (p = 0.001). Retreatment was required for 47 patients (34.8%). Univariate and multivariate analysis showed that the only baseline parameters able to predict the long-term efficacy were a IPSS <18 and a Qm, > 10 ml/sec (p = 0.04).
  
  
  CONCLUSIONS
  These data shows a high response rate obtained with 30-minute TUMT protocol and a durability of response up to 5 years after treatment, making this procedure a safe and effective alternative to TURP in selected patients.
authors.affiliation: Department of Emergency and Organ Transplantation, Urology, Andrology and Kidney Transplantation Unit, University of Bari, Italy. giuseppe.lucarelli@inwind.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lucarelli
authors.forename: Michele
authors.initials: M
authors.lastname: Battaglia
authors.forename: Carlo
authors.initials: C
authors.lastname: Bettocchi
authors.forename: Roberto
authors.initials: R
authors.lastname: Peschechera
authors.forename: Gaetano Valerio
authors.initials: GV
authors.lastname: Palella
authors.forename: Pasquale
authors.initials: P
authors.lastname: Martino
authors.forename: Silvano
authors.initials: S
authors.lastname: Palazzo
authors.forename: Gabriele Alberto
authors.initials: GA
authors.lastname: Saracino
authors.forename: Francesco Paolo
authors.initials: FP
authors.lastname: Selvaggi
authors.forename: Pasquale
authors.initials: P
authors.lastname: Ditonno
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011470:Prostatic Hyperplasia / Q000601:surgery*; D013997:Time Factors; D020728:Transurethral Resection of Prostate