Results of high-energy transurethral microwave thermotherapy in patients categorized according to the American Society of Anesthesiologists operativerisk classification

Objectives. To evaluate the relation between the American Society of Anesth esiologists (ASA) classification and response to transurethral microwave th ermotherapy (TUMT) in patients with lower urinary tract symptoms and benign prostatic hyperplasia (BPH). Methods. Two hundred forty-seven patients with symptomatic BPH treated with high-energy TUMT were scored retrospectively for ASA status. Student's t t est was used to determine differences in improvement at each point of follo w-up between patients classified as ASA 1 or 2 and patients classified as A SA 3 or 4. Logistic regression analysis was performed to assess the predict ive value of ASA status for response using the World Health Organization re sponse evaluation criteria for International Prostate Symptom Score, maxima l flow rate, and urodynamic obstruction. Results. There was a significant improvement in objective and subjective pa rameters at 12, 26, and 52 weeks of follow-up in both ASA 1 and 2 patients and ASA 3 and 4 patients. There was no difference in objective and subjecti ve improvement between both groups at each point of follow-up. Objective an d subjective improvement in ASA 3 and 4 patients with cardiovascular diseas e and ASA 3 and 4 patients with noncardiovascular disease was the same, alt hough patients with cardiovascular disease received less energy during TUMT . Using logistic regression analysis, ASA classification was not predictive of response after high-energy TUMT. Conclusions. There is no relation between ASA classification and outcome af ter high-energy TUMT. Because these patients are considered at high risk of perioperative complications and postoperative morbidity, TUMT could contri bute considerably to the treatment of BPH in this specific group of patient s. (C) 1999, Elsevier Science Inc. All rights reserved.