TRANSURETHRAL MICROWAVE THERMOTHERAPY FOR BENIGN PROSTATIC HYPERPLASIA - CLINICAL OUTCOME AFTER 4 YEARS

Purpose: We describe long-term results of transurethral microwave ther motherapy. We determined pretreatment variables favorable for the outc ome. Materials and Methods: We followed for 4 years 187 patients treat ed with Prostatron software 2.0. Preoperative evaluations consisted o f score, cystoscopy, transrectal ultrasonography, urine flow and resid ual volume measurements. Followup examinations with score and urodynam ics were performed for 4 years after transurethral microwave thermothe rapy. Kaplan-Meier plots and logistic regression were used for statist ical analyses. Results: A decrease in the number of satisfied patients was noted from 62% at 1 year after transurethral microwave thermother apy to 23% at 4 years. Initial decrease in score and increase in urine flow were followed by increase in score and decrease in flow at the 4 -year followup of the 56 patients who had not received supplementary b enign prostatic hyperplasia (BPH) treatment. The Kaplan-Meier analysis estimated the median time for need of supplementary BPH treatment to be 45 months. Pretreatment urine flow greater than 10 ml. per second a nd an irritative score less than 5 were the only factors related to a favorable outcome. Prostate volume or energy delivered to the prostate did not influence the result. Conclusions: Four years after transuret hral microwave thermotherapy 23% of the initially treated group were s atisfied with the result. Two-thirds had received supplementary BPH tr eatment. Preoperatively less obstructed patients and those with low in itial irritative scores responded more favorably to transurethral micr owave thermotherapy treatment.