Transurethal microwave thermotherapy for benign prostatic hyperplasia

Abstract

(Background) We studied the clinical efficacy of transurethral microwave thermotherapy (TUMT) Using Endotherm UMW(TM) system (OLYMPUS). (Methods) TUMT was performed in 28 patients with benign prostatic hyperplasia (BPH). Three patients of them were catheterized because of urinary retention. The treatment was performed in a single session for an hour. The urethral surface temparature was set at 39°C, and the coolant flow of the urethral applicator (21 Fr balloon catheter) was set at 30 ml/min, to heat up the broad area of the prostate up to 45°C. The clinical efficacy was evaluated by analyzing subjective responses, using the International Prostate Symptom Score (I-PSS) scale (S) and QOL score (L), and objective responses, using peak urinary flow rate (Qmax), average flow rate (Qave), residual urine volume and prostate volume following the treatment. (Results) At 24 weeks after the treatment, significant improvement were observed in S score (41%), L score (37%), Qmax (53%) and Qave (62%). Although there was no significant decrease in residual urine and prostate volume. The three patients, with a catherer indwelled because of urinary retention, were all free of the catheter within 4 weeks after the treatment. During and after the treatment, no severe adverse effects, including transient urinary retention needed for indwelling a catheter, was detected. (Conclusion) A single session of TUMT by Endotherm UMW(TM) considered to be safe and useful for symptomatic BPH patients, even who are not indicated for transUrethral resection of the prostate (TUR-P) because of underlying disorders.