PRESSURE-FLOW STUDIES BEFORE AND AFTER TRANSURETHRAL MICROWAVE THERMOTHERAPY OF BENIGN PROSTATIC HYPERPLASIA USING LOW-ENERGY AND HIGH-ENERGY PROTOCOLS

Objective To compare pressure-flow results before and 3 months after t ransurethral microwave thermotherapy (TUMT) for benign prostatic hyper plasia (BPH), per formed with lower and higher energy protocols. Patie nts and methods Twenty-four patients were treated using a high-energy protocol performed with a heat-shock strategy, i.e, a rapid increase i n intraprostatic temperatures to a maximum of 55-67 degrees C. A helic al antenna was used which produced maximum heating at the base of the prostate. A further 25 patients were treated using a lower energy prot ocol with a slow increase in intraprostatic temperatures to a maximum of 45-53 degrees C. A first-generation filament antenna was used with the maximum heat produced at the prostatic apex. All treatments were p erformed as single-session outpatient procedures of 60-70 min duration . Results There was a significantly greater improvement in pressure-fl ow variables, i.e. maximum urinary flow rate, detrusor pressure at max imum flow and minimal urethral opening pressure, in those treated with higher energy TUMT than in those receiving the lower energy protocol. The Madsen and quality-of-life scores, and maximum urinary flow rate on uroflowmetry, were also significantly better in the higher energy g roup. Conclusion Higher energy TUMT performed using a heat-shock strat egy provides a better pressure-flow outcome than lower energy thermoth erapy. Compared with previously published results, the outcome after h igher energy TUMT is at least similar to other treatment alternatives for BPH.