TRANSURETHRAL MICROWAVE THERMOTHERAPY OF BENIGN PROSTATE HYPERPLASIA

The results of the treatment of 50 patients at the initial stage of be nign prostate hyperplasia (BPH) in the age from 54 to 85 years (averag e: 67.5) by transurethral microwave thermotherapy (TUMT) on the instru ment Prostcare (Bruker Spectrospin SA, France) are discussed. For 10 p atients with cystostoma TUMT has been applied as preparation for surgi cal intervention. The TUMT was performed in one session of 1 hour at t emperatures of 45-50 degrees C. During the session no complications ha ve been observed and the procedure was well tolerated by the patients. Indications and contraindications are discussed. It is emphasized, th at presence of stones and the size of BPH were of no importance for TU MT. Among the side effects of TUMT 15 patients (30%) exhibited moderat e macrohematuria, 6 (12%) acute urinary retention and 2 (4%) urethral fever. The treatment results have been followed up in 35 patients at 1 , 3, 6 and 12 months. For 23 of 25 patients (92%) improvement of urina tion was observed 2-3 weeks after TUMT. The maximal flow rate increase d in the average by 4.5 ml/sec. Regression of BPH site was observed in 30 of 35 patients (85.7%). For 2 patients (8%) with prevailing develo pment of the central lobe of the prostate, TUMT proved to be ineffecti ve. Recurrence of clinical symptoms of BPH was observed for 2 (8%) pat ients within 6 months after the treatment. In 3 patients the cystostom a healed up within 2-8 weeks after TUMT, 4 cystostomic patients receiv ed transurethral resection with minimal risk of bleeding and good resu lt. After 6 months, 28 of 35 patients (80%) and the two patients obser ved after one year retained a stable positive effect of the treatment. Subjective improvement was obtained for 23 of 25 patients (92%) and o bjective improvement for 30 of 35 (85.7%). The authors recommend TUMT for treating the initial stage of BPH and for the preparation of patie nts for surgical intervention.