Objective: We report on our experience with a less invasive treatment for benign prostatic hyperplasia (BPH), a high-energy '30-minute' treatment algorithm of transurethral microwave thermotherapy (TUMT). As initial investigators of this new device, we have tested its safety, tolerance and efficacy.
Methods: From April 1998 to May 1999, all males attending our Outpatient Clinic for symptomatic BPH were evaluated with physical examination, symptoms questionnaire, bladder and prostate ultrasound scan, cystomanometry and pressure-flow study. Sixty-one males with: prostate volume > 30 cm3, prostate length > 25 mm, Qmax < 15 ml/s, IPSS > or =13, MSS > or = 8, and without excessive middle lobe, underwent one session of 30-min TUMT treatment after informed consent was obtained. Treatments were performed on an outpatient basis and with oral sedation and local analgesia. Follow-up visits were scheduled for 2 weeks, 1, 3, 6 and 12 months post-treatment.
Results: Fifty-six out of 61 patients (92%) completed the 6-month follow-up visit: mean MSS improved from 12.0 to 4.3; IPSS changed from 18.1 to 5.2. The mean maximum flow rate improved from 9.1 to 17.8 ml/s and the mean post-void residual decreased from 92 to 18 ml. Cavities within prostatic tissue were observed in 54 out of 56 patients (95%). The most frequent adverse event was UTI (21.3%); no major complications were observed.
Conclusion: Our experience demonstrated that 30-min TUMT is a safe, effective and well-tolerable treatment for patients with BPH and LUTS, although further studies are needed to assess result durability and long-term efficacy.