TRANSURETHRAL MICROWAVE TREATMENT FOR BENIGN PROSTATIC HYPERTROPHY - A RANDOMIZED CONTROLLED CLINICAL-TRIAL

Objectives-To determine whether transurethral microwave treatment for patients with benign prostatic hypertrophy provides significant sympto matic relief, a reduction in residual urine volumes, and improvements in flow rates compared with sham treatment. Design-Prospective double blind randomised study with follow up at three months. Setting-Departm ent of Urology in a London teaching hospital. Patients-40 men complete d the study: 22 received microwave treatment and 18 received sham trea tment. Entry criteria were symptoms of prostatism of at least six mont hs' duration, a total symptom score > 14, and a peak urine flow rate < 15 ml/s or a residual urine volume > 50 ml. Exclusion criteria were p rostatic cancer, a residual urine volume > 200 ml, a very large prosta te, an obstructing middle lobe, acute urinary retention, impaired rena l function, coexisting urinary tract disease, and previous prostatic s urgery. Interventions-A single 90 minute transurethral microwave treat ment or sham treatment. Outcome measures-Patients' symptoms (including daytime frequency and nocturia) recorded in a self assessment symptom score questionnaire, peak urinary flow rates, and residual urine volu mes. Results-The mean total symptom scores of the patients who receive d microwave treatment fell from 30 to 11 compared with a fall from 31 to 26 for patients who received sham treatment (p < 0.001). Among pati ents who received microwave treatment daytime frequency fell from 9.4 to 5.5 voids a day and night time frequency from 3.5 to 1.6 voids a ni ght; residual urine volumes fell from 104 ml to 52 ml; and peak urine flow rates increased by 2.3 ml/s. In the control group there was no im provement in any of these features. Treatment preserved sexual functio n and antegrade ejaculation. Conclusions-For selected patients with pr ostatism microwave treatment is effective and has few side effects.