Transurethral microwave thermotherapy versus transurethral catheter therapy for benign prostatic hyperplasia

Transurethral microwave thermotherapy (TUMT) is a single outpatient treatment for benign prostatic hyperplasia. It produces good symptomatic relief but minimal objective improvement in mean flow rates. We wished to evaluate the placebo effect of the transurethral catheter. We evaluated 40 patients with outflow obstruction, 20 had TUMT for 1 h and 20 had a catheter placed in the urethra without treatment for 1 h. Urinary flow rates improved in both groups (12.8-14.6 with TUMT, 10.0-12.4 with catheter). Significant reduction from pretreatment values occurred in symptom scores and postvoid residual urine volume in both groups following treatment. The subjective results of TUMT and the placebo effect seen in the catheter group cast doubt on our understanding of the mechanism of action of TUMT.