TRANSURETHRAL MICROWAVE THERAPY - PATIENT SELECTION AND OUTCOME

Forty-one patients with benign prostatic disease awaiting transurethra l resection of the prostate were offered transurethral microwave thera py as an alternative. Pre-operative assessment consisted of symptom sc ores, prostate-specific antigen levels, flow rates and urinary tract u ltrasound with residual urine estimation. Patients were reassessed 6 w eeks, 3 months and 6 months after microwave treatment. Twenty-three pa tients had a successful outcome and 18 an unsuccessful outcome to trea tment. Fifteen of the 18 with an unsuccessful outcome could have been predicted by the presence of one or more of the following pretreatment features: glands over 50 g (10 patients), the presence of a median lo be (5 patients), high residual urine (6 patients), a history of recurr ent urinary infection (2 patients) and coexisting neurological disorde rs such as parkinsonism (1 patient) and CVA (1 patient). Three failure s had none of these criteria present and could not have been predicted from their pretreatment assessment. Transurethral microwave therapy p roduces subjective and objective improvements in appropriately selecte d patients. Patients with large glands or decompensated bladders fail to benefit and should continue to be treated by conventional surgery.