SHAM CONTROLLED TRIAL OF TRANSURETHRAL MICROWAVE THERAPY WITH SUBSEQUENT TREATMENT OF THE CONTROL-GROUP

To investigate whether there is a significant placebo component to the improvements seen after 1-session transurethral microwave treatment, 40 patients with significant symptoms of prostatism and unequivocally benign glands were recruited to take part in a sham controlled study. After an active treatment the mean American Urological Association sym ptom scores improved by 63% (19.2 to 7.1) while after a sham treatment symptom scores improved only marginally (18.8 to 16.2, p < 0.001). Re sidual volumes decreased by 50% (104 to 52 ml.) and flow rates increas ed by 2.3 ml. per second after an active treatment with no improvement after a sham treatment. There was a consistently greater improvement after an active treatment compared to a sham treatment. Patients who h ad received a sham treatment were then offered an active treatment and showed improvements similar to those in the original actively treated group and much greater than after the original sham treatment. Mean s ymptom scores decreased from 16.2 to 9.9 (p < 0.004). Residual volumes decreased from 94 to 40 ml. (p < 0.005) and flow rates increased by 1 .6 ml. per second, while these same criteria had deteriorated after a sham treatment. Side effects were mild and short li ved, with no patie nts reporting sexual dysfunction as a consequence of treatment. Transu rethral microwave therapy is an effective well tolerated treatment for select patients with benign prostatic hypertrophy and the placebo eff ect of treatment is minimal.