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Prostatic heat treatments for urinary outflow obstruction
A P Perlmutter1, J Verdi, G M Watson
1Institute of Urology, London, England.
The Journal of Urology
|November 1, 1993
Summary
Benign prostatic hyperplasia (BPH) treatments using prostatic heating devices showed varied success. Some patients experienced sustained symptom relief, but outcomes were not predictable by initial health metrics.
Area of Science:
- Urology
- Medical Devices
- Minimally Invasive Therapies
Background:
- Symptomatic benign prostatic hyperplasia (BPH) affects a significant number of men.
- Various treatment modalities exist, with a need for effective and minimally invasive options.
Purpose of the Study:
- To evaluate the efficacy of three different prostatic heating devices for treating symptomatic BPH.
- To assess long-term outcomes and identify predictors of treatment success.
Main Methods:
- A nonrandomized pilot study involving 139 patients with symptomatic BPH.
- Treatment with transrectal hyperthermia (Biodan Prostathermer, Primus Prostate Machine) and transurethral thermotherapy (Thermex-II).
- Follow-up assessments at 1 and 2.5 years, including symptom scores and need for further treatment.
Main Results:
- At 2.5 years, 37-40% of patients treated with transrectal devices had sustained improvement without further intervention.
- At 1 year, 55% of patients treated with Thermex-II had satisfactory results, but 40% required transurethral resection of the prostate (TURP).
- Treatment failure rates increased over time; pretreatment parameters did not predict success.
Conclusions:
- Prostatic heating devices offer symptomatic improvement for a subset of BPH patients.
- These devices have a limited impact on peak urinary flow rate.
- Predictive factors for successful outcomes remain elusive, highlighting the need for further research.