Clinical efficacy of a new 30‐min algorithm for transurethral microwave thermotherapy: initial results

• Published in: BJU international 2000-07, Vol.86 (1), p.47-51
• Main Authors: De La Rosette, J.J.M.C.H., Francisca, E.A.E., Kortmann, B.B.M., Floratos, D.L., Debruyne, F.M.J., Kiemeney, L.A.L.M.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Algorithms; benign prostatic hyperplasia; Biological and medical sciences; BPH; Diseases of the urinary system; efficacy; Follow-Up Studies; Humans; Hyperthermia, Induced - methods; Male; Medical sciences; Microwaves - therapeutic use; Middle Aged; outcome; Prostatic Hyperplasia - physiopathology; Prostatic Hyperplasia - therapy; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Transurethral microwave thermotherapy; Treatment Outcome; Urination - physiology; Urination Disorders - physiopathology; Urination Disorders - therapy; Urodynamics
• ISSN: 1464-4096; 1464-410X
• DOI: 10.1046/j.1464-410x.2000.00732.x

Objective To assess the efficacy of a new 30‐min algorithm for high‐energy transurethral microwave thermotherapy (TUMT, Prostasoft 3.5) in the treatment of men with lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia. Patients and methods A total of 108 men (mean age 66 years) with bothersome LUTS were treated with the new TUMT protocol. All patients were evaluated using a standard assessment at baseline, 6, 12, 26 and 52 weeks after TUMT. The evaluation included the assessment of objective and subjective outcome measures, with a urodynamic evaluation using pressure‐flow analysis, and the occurrence of adverse events. Results The treatment was well tolerated. In general, the International Prostate Symptom Score improved from a mean of 20.0 at baseline to a mean of 9.3 at 6 months after treatment. The maximum urinary flow improved from 9.4 mL/s to 14.6 mL/s at 6 months. The mean duration of catheterization was 17.9 days. The urodynamic evaluation showed a change from the obstructed to the equivocal zone on the Abrams–Griffith nomogram. There were no serious complications. Urgency and frequency were the most frequent side‐effects after treatment; these all resolved within 3 months. Conclusion High‐energy TUMT using the new high‐dose Prostasoft 3.5 protocol appears to be a safe and effective treatment. The faster procedure improves the tolerance of the treatment. The subjective and objective improvements were significant and the treatment‐related morbidity low. A longer follow‐up is needed to assess the durability of this new treatment protocol.