Initial experience with a new transurethral microwave thermotherapy treatment protocol '30-minute TUMT'

We report on our experience with a less invasive treatment for benign prostatic hyperplasia (BPH), a high-energy '30-minute' treatment algorithm of transurethral microwave thermotherapy (TUMT). As initial investigators of this new device, we have tested its safety, tolerance and efficacy.

From April 1998 to May 1999, all males attending our Outpatient Clinic for symptomatic BPH were evaluated with physical examination, symptoms questionnaire, bladder and prostate ultrasound scan, cystomanometry and pressure-flow study. Sixty-one males with: prostate volume > 30 cm3, prostate length > 25 mm, Qmax < 15 ml/s, IPSS > or =13, MSS > or = 8, and without excessive middle lobe, underwent one session of 30-min TUMT treatment after informed consent was obtained. Treatments were performed on an outpatient basis and with oral sedation and local analgesia. Follow-up visits were scheduled for 2 weeks, 1, 3, 6 and 12 months post-treatment.

Fifty-six out of 61 patients (92%) completed the 6-month follow-up visit: mean MSS improved from 12.0 to 4.3; IPSS changed from 18.1 to 5.2. The mean maximum flow rate improved from 9.1 to 17.8 ml/s and the mean post-void residual decreased from 92 to 18 ml. Cavities within prostatic tissue were observed in 54 out of 56 patients (95%). The most frequent adverse event was UTI (21.3%); no major complications were observed.

Our experience demonstrated that 30-min TUMT is a safe, effective and well-tolerable treatment for patients with BPH and LUTS, although further studies are needed to assess result durability and long-term efficacy.