A novel intraurethral prostatic bridge catheter for prevention of temporary prostatic obstruction following high energy transurethral microwave thermotherapy in patients with benign prostatic hyperplasia

Purpose. We evaluate the efficacy and safety of a novel intraurethral prost atic bridge catheter in preventing temporary prostatic obstruction followin g targeted high energy transurethral microwave thermotherapy in patients wi th benign prostatic hyperplasia. Materials and Methods. A total of 54 patients with benign prostatic hyperpl asia underwent high energy transurethral microwave therapy under topical ur ethral anesthesia followed by placement of a prostatic bridge catheter, whi ch remained indwelling as long as 1 month (prostatic bridge catheter group) . Patient evaluation included determination of peak urinary now rate, inter national Prostate Symptom Score (I-PSS) and quality of life score at baseli ne, immediately following transurethral microwave therapy and prostatic bri dge catheter placement, and periodically thereafter for 1 month. Results we re retrospectively compared with those of 51 patients who underwent transur ethral microwave therapy followed by standard temporary urinary catheteriza tion, typically for 24 hours (standard catheterization group). Results. Immediately following transurethral microwave therapy and prostati c bridge catheter placement significant improvements (p < 0.0005) were obse rved in mean peak flow rate, I-PSS and quality of life score of 59.3, 33.5 and 23.6%, respectively, compared with baseline values. Further improvement s were noted up to 1 month, at which time mean peak flow rate, I-PSS and qu ality of life score had improved 79.0, 54.9 and 56.5%, respectively, versus baseline (p < 0.0005). In a retrospective comparison at baseline and 14 da ys between the prostatic bridge catheter group and standard catheterization group mean baseline peak flow rate, I-PSS and quality of life score were s imilar. However, at the 14-day followup evaluation in the prostatic bridge catheter group mean peak now rate was 101.8% higher, and I-PSS and quality of life score were 47.9 and 51.1% lower, respectively, than the correspondi ng values in the standard catheterization group (p < 0.0005). The prostatic bridge catheter was well tolerated and remained indwelling throughout the entire 1-month followup in 48 of 54 patients (88.9%). Early prostatic bridg e catheter removal was required in 3 patients (5.6%) due to urinary retenti on and in 3 (5.6%) due to catheter migration. Conclusions. Prostatic bridge catheter placement provides an effective and well tolerated option for preventing prostatic obstruction in the acute per iod after transurethral microwave therapy. This approach avoids the inconve nience and infection risk of standard indwelling catheters or intermittent self-catheterization. Prostatic bridge catheter insertion and removal are r apid, facile, nontraumatic procedures. Prostatic bridge catheter may potent ially be used in an array of minimally invasive procedures involving therma l treatment of the prostate gland.