TEMPERATURE-CONTROLLED HIGH-ENERGY TRANSURETHRAL MICROWAVE THERMOTHERAPY FOR BENIGN PROSTATIC HYPERPLASIA USING A HEAT-SHOCK STRATEGY

Purpose: We evaluate the clinical outcome of temperature controlled hi gh energy transurethral microwave thermotherapy for benign prostatic h yperplasia using heat shock strategy. Materials and Methods: A total o f 32 patients were evaluated 3, 6 and 12 months after thermotherapy ac cording to symptom scores, uroflowmetry, residual urine volume, sexual functions and side effects. Results: At 12 months symptom score and m aximum flow rate had improved 79% from 13.5 to 2.9, and 71% from 10.0 to 17.1 ml. per second, respectively. Furthermore, bother and quality of life scores and residual and voided urine volumes had improved sign ificantly, However, a higher morbidity than previously shown after low er energy protocols was demonstrated. Treatment influenced sexual func tions, especially ejaculation quality, and after treatment 29% of the patients had anejaculation. Significantly less energy was required for prostate volumes 40 ml. or greater to reach the same intraprostatic t emperature level as those less than 40 mi. as demonstrated by radiomet ry. Conclusions: High energy transurethral microwave thermotherapy usi ng a heat shock strategy is an effective treatment for benign prostati c hyperplasia. and produces a better outcome than shown with lower ene rgy protocols. However, the morbidity is not negligible and ejaculatio n quality is affected. Less relative energy is needed for large than s mall prostate volumes to reach the same intraprostatic temperature lev el as demonstrated by radiometry.