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Morphological changes in prostatic adenomas after transurethral microwave thermotherapy
1Department of Urology, South Hospital, Stockholm, Sweden.
British Journal of Urology
|July 1, 1997
Summary
Transurethral microwave thermotherapy (TUMT) causes limited prostatic tissue damage, primarily necrosis and apoptosis, in benign prostatic hyperplasia patients. This heat-induced cell death is localized and does not involve significant inflammation.
Area of Science:
- Urology
- Pathology
Background:
- Benign prostatic hyperplasia (BPH) is a common condition in aging men.
- Transurethral microwave thermotherapy (TUMT) is a minimally invasive treatment for BPH.
Purpose of the Study:
- To investigate the extent and nature of tissue damage in prostatic adenomas following TUMT.
- To analyze histopathological changes and identify cellular mechanisms of damage induced by TUMT.
Main Methods:
- Seven BPH patients scheduled for adenectomy underwent TUMT at varying intervals before surgery.
- Excised adenomas were analyzed using routine light microscopy and the TUNEL technique for DNA fragmentation.
- TUNEL staining assessed apoptosis in areas with morphological alterations.
Main Results:
- Histopathological changes were observed in limited areas (20-25 mm from the urethra) in six patients.
- Predominant findings included necrosis surrounded by cells exhibiting apoptotic features (TUNEL-positive).
- One patient with inadequate TUMT showed no significant heat-induced tissue damage.
Conclusions:
- TUMT induces localized tissue damage in BPH adenomas, characterized by necrosis and apoptosis.
- Apoptosis, a discrete cell death form without inflammation, occurs at temperatures below those causing necrosis.
- The overall area of TUMT-induced damage is small relative to prostate volume.