Transurethral hyperthermia for benign prostatic hyperplasia: long term results

Area of Science:

• Urology
• Minimally Invasive Therapies
• Medical Devices

Background:

• Transurethral resection of the prostate (TURP) is the standard treatment for benign prostatic hyperplasia (BPH).
• An alternative treatment is needed for patients who decline TURP.
• Transurethral hyperthermia (TUHT) was investigated as a potential alternative.

Purpose of the Study:

• To evaluate the safety and efficacy of Transurethral hyperthermia (TUHT) in patients with benign prostatic hyperplasia (BPH).
• To assess TUHT as an alternative treatment for patients unwilling to undergo Transurethral resection of the prostate (TURP).

Main Methods:

• A phase I trial involving 21 BPH patients with moderate to severe symptoms treated with TUHT.
• TUHT sessions averaged 8.4 sessions of 60 minutes each, maintaining urethral temperatures between 40.3°C and 49.2°C.
• Patient outcomes were assessed using subjective (Total Symptom Score) and objective (Peak Flow Rate, Post-Voiding Residual Volume, Prostate Volume) parameters.

Main Results:

• TUHT demonstrated excellent tolerance with minor, transient acute toxicity (71% of patients) and no late complications.
• Significant improvements were observed at 6 months: 81% showed objective improvement and 71% subjective improvement.
• Long-term follow-up showed sustained response in 9 out of 17 patients for over six years, with two relapses.

Conclusions:

• Transurethral hyperthermia (TUHT) is an effective treatment for benign prostatic hyperplasia (BPH) with minimal toxicity.
• TUHT offers a viable alternative to Transurethral resection of the prostate (TURP) for select patients.
• Further prospective randomized trials are recommended to establish the definitive role of TUHT in BPH management.