High-energy transurethral microwave thermotherapy in patients with acute urinary retention due to benign prostatic hyperplasia

Objectives. To evaluate the efficacy and safety of targeted high-energy tra nsurethral microwave thermotherapy (HE-TUMT) in the treatment of acute urin ary retention (AUR) due to benign prostatic hyperplasia (BPH). Methods. In this prospective cohort study, 31 patients with painful AUR due to BPH underwent HE-TUMT. Patient evaluation before treatment and during a 12-week follow-up interval included determination of International Prostat e Symptom Score (IPSS), quality of life (QOL) score, peak flow rate (Qmax) by uroflowmetry, and postvoid residual urine. Patients also underwent urody namic evaluation before treatment and at 16 weeks. Results. By 4 weeks after HE-TUMT, 29 (94%) of 31 patients had regained the ability to void spontaneously. The actuarial median time for restoration o f spontaneous voiding was 3.0 weeks (95% confidence interval [CI] 2.2 to 3. 8). At 12 weeks, the mean IPSS (9.4; 95% CI 8.3 to 10.5) was 50% below (P < 0.0005) that before retention (18.9; 95% CI 18.2 to 19.6). Improvements in the mean QOL score were similar in pattern and relative magnitude to those in the mean IPSS. A 69% increase in mean Qmax (P <0.0005) determined by uro flowmetry was observed by 12 weeks versus 1 week after HE-TUMT. Complicatio ns were infrequent. Conclusions. This study provides preliminary evidence that HE-TUMT may pote ntially afford a novel and useful option for the patient with AUR who is no t a suitable candidate for surgery. UROLOGY 54: 18-22, 1999. (C) 1999, Else vier Science Inc.