HIGH-ENERGY TRANSURETHRAL MICROWAVE THERMOTHERAPY FOR LARGE SEVERELY OBSTRUCTING PROSTATES AND THE USE OF BIODEGRADABLE STENTS TO AVOID CATHETERIZATION AFTER TREATMENT

Objective To assess the use of high-energy transurethral microwave the rmotherapy (TUMT) for large severely obstructing benign prostatic hype rplasia (BPH) and to compare the use of a biodegradable stent with tha t of a urethral Foley catheter after TUMT. Patients and methods The st udy comprised 30 men (mean age 71 years, range 49-82) scheduled for pr ostatectomy for symptomatic BPH. Pre-operative investigations included the measurement of urinary free flow rate, residual urine volume (ult rasonographically), a digital rectal examination, transrectal ultrason ography, a symptom score, cystoscopy, cystometry and pressure-flow. Th e obstruction was graded according to the Schafer nomogram. The patien ts were treated using the Prostatron (EDAP-Technomed, France) TUMT sys tem; the software used provided a maximum power of 70 W. Patients were catheterized after treatment with either a Foley catheter or a biodeg radable stent. After 3 months, the measurements and obstruction gradin g were repeated, and the effect of the stent assessed. Results In the entire group, the mean (so) free now increased from 7.7 (2.4) to 14.0 (3.3) mL/s, the residual urine decreased from 125 (86) to 23 (25) mt a nd the symptom score decreased from 16 (8) to 5 (4). The mean (so) deg ree of obstruction decreased from 81.0 (16) to 62.6 (15). The biodegra dable stent completely avoided post-treatment retention. Conclusion Hi gh-energy TUMT can be used on large severely obstructing prostates wit h major subjective and objective improvements. The biodegradable stent is useful in relieving the problems of catheterization after treatmen t.