High energy transurethral microwave thermotherapy for the treatment of patients in urinary retention

Purpose: We evaluated the efficacy of high energy transurethral microwave t hermotherapy for treating urinary retention due to benign prostatic hyperpl asia. Materials and Methods: Between October 1993 and March 1999, 41 patients wit h urinary retention were treated with high energy transurethral microwave t hermotherapy. Initial evaluation consisted of a history, clinical examinati on, urethrocystoscopy, transrectal prostate ultrasonography and urodynamic investigation with a pressure flow study. Followup visits at 12, 26 and 52 weeks included International Prostate Symptom Score (I-PSS), uroflowmetry a nd post-void residual urine volume determination. At 26 weeks the urodynami c study was repeated. Kaplan-Meier plots were constructed to evaluate the r isk of re-treatment adjusted for patients lost to followup. Results: At baseline median patient age was 74 years sind median prostate s ize was 67 mi. Median 133 kJ. were administered. Nine patients underwent re -treatment and 11 were lost to followup. The re-treatment rate after 1 year was 25% (95% confidence interval 11 to 40). In good responders at 12, 26 a nd 52 weeks median maximal urine free flow was 15, 11 and 15 mi. per second , post-void residual urine volume was 61, 8 and 35 mi., and I-PSS was 7, 5 and 2, respectively. Quality of life (I-PSS question 8) was 1 at all visits . Conclusions: In patients with severe co-morbidity transurethral microwave t hermotherapy is often the only alternative to an indwelling catheter with o bvious quality of life advantages. High energy transurethral microwave ther motherapy appears to be effective in these patients.