[Transurethral microwave-thermotherapy in the treatment of benign prostatic hyperplasia]. / Transurethrale microgolf-thermotherapie bij de behandeling van benigne prostaathyperplasie.

ABSTRACT

OBJECTIVE: Determining the therapeutic efficacy of transurethral microwave thermotherapy (TUMT) in benign prostatic hyperplasia (BPH). DESIGN: Prospective. SETTING: Department of Urology, University Hospital Nijmegen, the Netherlands. METHOD: In the outpatient clinic, 130 BPH patients (mean age 65.9 years (SD 6.9); mean prostatic volume 50.2 cm3 (SD 18.4)) received TUMT in a single session lasting 60 min. The prostate was heated to above 45 degrees C by a microwave antenna in a urethral catheter, resulting in tissue necrosis. In the first year after treatment the Madsen symptom score, maximal flow, residual volume, prostatic volume and concentration of prostate-specific antigen in blood were collected. RESULTS: After 1 year 98 patients could be evaluated; of the other 32, 16 withdrew from follow-up, 10 underwent transurethral prostate resection and 6, other treatment. The maximal flow increased by 1.2 ml/s (SD 4.0). The residual volume decreased by 15.8 ml (SD 55.6). Symptom scores improved by 5.9 points (SD 5.0). A 50% increase in symptom score was seen in 49.5% of all patients; 24.3% showed no improvement of complaints. There was no change in prostatic volume, whereas PSA concentration showed a transient increase in the first week after TUMT. Preliminary results after 6 months' follow-up of a randomised placebo-controlled study in 50 patients showed subjective and objective improvement of miction. CONCLUSION: TUMT results in distinct subjective improvement. Urodynamic findings show a less pronounced improvement.