RESUMO
Transurethral microwave thermotherapy is a minimally invasive treatment for benign prostatic hyperplasia designed to destroy hyperplastic tissue without damaging the urethra. We present an unexpected complication of prostatic urethral necrosis and tissue sloughing after thermotherapy and discuss its possible cause.
Assuntos
Hipertermia Induzida/efeitos adversos , Lesões por Radiação/patologia , Lesões dos Tecidos Moles/patologia , Uretra/patologia , Idoso , Seguimentos , Humanos , Masculino , Micro-Ondas/efeitos adversos , Necrose , Prostatectomia , Hiperplasia Prostática/patologia , Hiperplasia Prostática/terapia , Lesões por Radiação/etiologia , Lesões dos Tecidos Moles/etiologia , Uretra/lesões , Uretra/efeitos da radiação , Obstrução Uretral/patologia , Obstrução Uretral/terapiaRESUMO
OBJECTIVES: This is the first and largest single institution retrospective study in the United States to examine the effects of transurethral microwave thermotherapy (TUMT) for the treatment of benign prostatic hyperplasia (BPH). METHODS: From September 1996 to June 1997, 78 men with moderate to severe symptomatic BPH were treated with the Prostatron at our institution. Patient age ranged from 52 to 85 years. Prostate volume ranged from 23 to 110 cc, and mean total energy applied during the treatment was 156.17 kJ. Patients were re-evaluated at 3 months and were asked to answer a questionnaire regarding their opinion about the treatment. RESULTS: At 3 months there was a significant decrease in mean symptom score from 19.6 to 11.2 (P <0.0001). Mean peak flow rate increased from 8.5 to 12.8 mLs (P <0.0001). Mean postvoid residual urine decreased from 56.8 to 22.0 mL (P <0.0001). We did not observe any severe complications. Unlike prior studies, we removed the Foley catheter, and patients performed clean intermittent catheterization (CIC) when necessary. There was no significant differences in subjective and objective parameters between these patients and those who did not need CIC. Patient opinion about the treatment was not affected by CIC. About two thirds (67.2%) of the patients in the study group were satisfied with the results of treatment, and 60.3% would undergo the same procedure again. CONCLUSIONS: TUMT of the prostate is an effective, safe, and acceptable form of treatment for patients with BPH. Longer follow-up is needed to examine the durability of TUMT treatment.