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Transurethral microwave therapy: patient selection and outcome
C J Bunce1, A S Bdesha, M Dinneen
1Department of Urology, St. Mary's Hospital, London, UK.
European Urology
|January 1, 1994
Summary
Transurethral microwave therapy offers symptom relief for benign prostatic disease. Pre-treatment assessment can predict treatment success, identifying patients likely to benefit from this alternative to surgery.
Area of Science:
- Urology
- Minimally Invasive Therapies
Background:
- Benign prostatic disease (BPD) affects a significant number of aging men.
- Transurethral resection of the prostate (TURP) is a common surgical treatment.
- Transurethral microwave therapy (TUMT) presents a less invasive alternative.
Purpose of the Study:
- To evaluate the efficacy of transurethral microwave therapy (TUMT) as an alternative to TURP for benign prostatic disease.
- To identify pre-treatment predictors of successful TUMT outcomes.
Main Methods:
- Forty-one patients with BPD awaiting TURP were offered TUMT.
- Pre-operative assessments included symptom scores, PSA, flow rates, and ultrasound with residual urine.
- Patients were reassessed at 6 weeks, 3 months, and 6 months post-treatment.
Main Results:
- Twenty-three patients (56%) experienced a successful outcome with TUMT.
- Fifteen of 18 unsuccessful outcomes were predicted by pre-treatment factors: large prostate size (>50g), median lobe, high residual urine, recurrent infections, or neurological disorders.
- Three treatment failures could not be predicted by initial assessment.
Conclusions:
- Transurethral microwave therapy provides subjective and objective improvements in carefully selected patients with benign prostatic disease.
- Patients with large prostates or significant bladder dysfunction are less likely to benefit from TUMT and may require conventional surgery.