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Temperature controlled high energy transurethral microwave thermotherapy for benign prostatic hyperplasia using a
1Department of Urology and Andrology, Umeå University, Sweden.
Purpose:
We evaluate the clinical outcome of temperature controlled high energy transurethral microwave thermotherapy for benign prostatic hyperplasia using heat shock strategy.
Materials And Methods:
A total of 32 patients were evaluated 3, 6 and 12 months after thermotherapy according to symptom scores, uroflowmetry, residual urine volume, sexual functions and side effects.
Results:
At 12 months symptom score and maximum flow rate had improved 79% from 13.5 to 2.9, and 71% from 10.0 to 17.1 ml. per second, respectively. Furthermore, bother and quality of life scores and residual and voided urine volumes had improved significantly. However, a higher morbidity than previously shown after lower energy protocols was demonstrated. Treatment influenced sexual functions, especially ejaculation quality, and after treatment 29% of the patients had anejaculation. Significantly less energy was required for prostate volumes 40 ml. or greater to reach the same intraprostatic temperature level as those less than 40 ml. as demonstrated by radiometry.
Conclusions:
High energy transurethral microwave thermotherapy using a heat shock strategy is an effective treatment for benign prostatic hyperplasia and produces a better outcome than shown with lower energy protocols. However, the morbidity is not negligible and ejaculation quality is affected. Less relative energy is needed for large than small prostate volumes to reach the same intraprostatic temperature level as demonstrated by radiometry.