CURRENT STATUS OF THERMOTHERAPY OF THE PROSTATE

Purpose: We reviewed the available data on transurethral microwave the rmotherapy in the treatment of patients with benign prostatic hyperpla sia (BPH). Furthermore we provide a perspective of this minimally inva sive treatment modality.Materials and Methods: To our knowledge all pr eviously reported data from clinical trials of transurethral microwave thermotherapy for BPH are reviewed. Results: Transurethral microwave thermotherapy was designed to apply microwave energy deep within later al prostatic lobes while simultaneously cooling the urethral mucosa, t hus enabling an outpatient based anesthesia-free procedure. Lower ener gy protocols using the Prostraton device provide significant symptoma tic improvement and improvement in maximum flow of approximately 35% o ver baseline. Similar changes are being documented with other transure thral microwave thermotherapy devices. Higher energy protocols using t he Prostatron device result in symptomatic improvement similar to that of lower energy protocols, while improvement in uroflowmetry is much more pronounced. However, the latter effect is achieved at the expense of increased morbidity. Second generation protocols have not yet been documented by users of the other thermotherapy devices. Conclusions: Numerous studies unequivocally support the efficacy and safety of tran surethral microwave thermotherapy for treatment of symptomatic BPH. Si gnificant improvement in objective and subjective parameters has been realized with transurethral microwave thermotherapy at multiple center s in the United States and Europe.