URODYNAMICS AND TRANSURETHRAL MICROWAVE THERMOTHERAPY

In this paper the role and value of urodynamic measurements in symptom atic benign prostatic hyperplasia (BPH) patients selected for transure thral microwave thermotherapy (TUMT) reviewed. Although pressure-flow studies alone can diagnose benign prostatic obstruction, the level of acceptance of urodynamic investigations in BPH remains low, reportedly due to their cost and to their invasive and time-consuming nature. Fu rthermore, the observation that extremely different treatment modaliti es in BPH have nearly the same symptomatic outcome, independently of t heir influence on obstruction, has played a part in raising doubt as t o the value of baseline urodynamics as a predictor of clinical success . Pre-and posttherapy urodynamic investigations in TUMT-treated patien ts have shown that urodynamic algorithms must be capable of distinguis hing between compressive and constrictive types of obstruction to docu ment the limited effects of low-energy TUMT on obstruction. Furthermor e, it has been shown that urodynamics evaluated in this way seems to b e the only predictor of the clinical success of TUMT when improvements in the objective parameters Q(max) (peak uroflow) and residual urine are included in the definition of outcome.