RADIOFREQUENCY HEAT-TREATMENT TO THE PROSTATE FOR BLADDER OUTLET OBSTRUCTION ASSOCIATED WITH BENIGN PROSTATIC HYPERPLASIA - A 4-YEAR OUTCOME STUDY

Objectives To evaluate the long-term effect on symptom relief and void ing performance of prostatic radiofrequency thermal treatment for blad der outlet obstruction (BOO) associated with benign prostatic enlargem ent (BPE). Patients and methods During 1991-1994, 151 patients (mean a ge 76 years, range 49-91) with symptomatic BOO associated with BPE (i. e. reduced urinary now rate and persistent residual urine) but with no clinical evidence of carcinoma of the prostate, were treated using th e Thermex II (Direx, Israel) intraurethral radiofrequency (RF) prostat ic thermal treatment system. This treatment raises the intraurethral t emperature to 48 degrees C for 3 h in a single session under local ana esthesia. The patients were followed using symptom scores and uroflowm etry for 24-48 months after treatment. Results At 1 year, 70% had a go od outcome, but by 3 years this had fallen to 40% and at 4 years to 22 %. An increase in mean urinary now rate, from 9 to 12 mL/s, was sustai ned throughout the follow-up. There was a reduction in mean residual u rine from 83 to 51 mt at 6 months, but this increased to 70 mL by 3 ye ars (not significant). The voiding pressure, which declined at 6-12 mo nths, increased again to near pre-treatment values at 1-2 years. Concl usions In patients with symptomatic BPE, prostatic thermal treatment w ith RF relieves symptoms in 60% for at least 2-3 years, In selected ca ses it is a useful form of management, as it can be performed as a day case with minimal risk. Changes in standard objective variables were s mall but statistically significant for at least one year. The study hi ghlights the importance of waiting for late results from clinical tria ls.