Transurethral microwave thermotherapy

Objectives and Methods: The present status of transurethral microwave therm otherapy (TUMT) in the low (LE) and high energy (HE) version is given as an overview. Results: With LE software, approximately 75% of patients will no te significant improvement with 65% reduction in symptom scores and a 35-40 % improvement in peak flow rate. Sham studies have shown statistically sign ificant improvement in treated patients compared to sham. Randomized studie s between TUMT and TURF show similar improvements in symptom scores with TU RF producing higher flow rates, as expected. Longterm studies have been rep orted to 5 years showing durability, although 10-20% of patients subsequent ly undergo TU RP. The clinical efficacy of HE-TU MT 2.5 has been documented in recently completed studies. Approximately 37% of patients develop cavit ation with HE-TUMT. The symptomatic improvement is similar between low and high energy while the flow rates with high energy improve by approximately 65%. Pressure flow studies have documented relief of obstruction in most of those patients who had obstruction prior to treatment. The morbidity of HE -TUMT in terms of retrograde ejaculation and posttreatment retention is hig her compared to the LE version. Conclusions: TUMT is a 1-hour outpatient, l ocal anesthetic procedure, minimally invasive treatment option for benign p rostatic hyperplasia that encompasses microwave radiative heating and water conductive cooling. TUMT has been proven both safe and efficacious for rel ieving benign prostatic hyperplasia symptoms in several large-scale control led studies. The existence of low and high energy versions offers the oppor tunity to select patients according to obstruction grade.