The predictive value of baseline variables in the treatment of benign prostatic hyperplasia using high-energy transurethral microwave thermotherapy

Objective To evaluate the combination of patient age, prostate size, grade of outlet obstruction and total amount of energy, all independent predictiv e variables of treatment outcome in patients with lower urinary tract sympt oms (LUTS) and benign prostatic hyperplasia (BPH) treated with high-energy transurethral microwave thermotherapy (HE-TUMT), and thus provide nomograms for predicting treatment outcome after HE-TUMT. Patients and methods Between October 1993 and July 1996, 247 patients with LUTS and BPH were treated with HE-TUMT using the Prostatron(TM) device, sof tware version 2.5 (EDAP Technomed, Lyon, Prance), The World Health Organisa tion Response Evaluation Criteria were used to evaluate the outcome, Patien t age, prostate volume, total amount of energy and grade of outlet obstruct ion were categorized using the Akaike information criterion (AIC). The prob abilities of a good/intermediate vs a poor response at 26 weeks according t o the AIC were calculated. Results Nomograms are presented providing the estimated probability (95% co nfidence interval) for a good/intermediate response of the evaluation of th e International Prostate Symptom Score at 26 weeks by categories of prostat e volume, total amount of TUMT energy and age, and of maximum urinary flow rate by categories of bladder outlet obstruction (linear passive urethral r esistance ratio, linPURR) and total amount of energy, and of linPURR by cat egories of prostate volume and total amount of energy. The total amount of energy appeared to have the most impact in the prediction of good/intermedi ate and poor response in all three response evaluation criteria, Conclusions These nomograms may assist urologists in making clinical recomm endations for the treatment of men with LUTS and BPH using HE-TUMT.