Tolerability of 3.5 versus 2.5 high-energy transurethral microwave thermotherapy

Purpose: To evaluate the tolerability of high-energy microwave thermotherap y in patients with benign prostatic hyperplasia (BPH) using two different t reatment protocols (Prostasoft 2.5 and Prostasoft 3.5). Materials and Methods: Pain and discomfort during treatment was evaluated u sing a visual analog scale in 39 patients undergoing 60-min Prostasoft 2.5 treatment and 41 patients undergoing 30-m in Prostasoft 3.5 treatment. The duration of transurethral microwave thermotherapy (TUMT) 3.5 treatment is s ignificantly shorter than TUMT 2.5 treatment. Results: The pain level is significantly higher at the beginning of the Pro stasoft 3.5 treatment compared to the Prostasoft 2.5 treatment. The reporte d pain level becomes similar 10 min into treatment, and remains similar to the end of the 3.5 treatment (at 30 min), when the pain level returns to ba seline. The 2.5 protocol patients experience continously increasing pain un til the end of the treatment at 60 min. One minute following termination of treatment, the pain level drops back to the baseline level. No correlation between the level of pain and the baseline subjective or objective voiding parameters was observed. A correlation is also absent between the pain lev el, age and catheterization time. There only seems to be a weak correlation between the pain level and TUMT energy in the Prostasoft 2.5 treatment gro up. Conclusions: Both TUMT 2.5 and TUMT 3.5 are well tolerated. Even though pat ients undergoing TUMT 3.5 treatment experience more discomfort initially, t he ultimate discomfort is similar to the TUMT 2.5 treatment, during the fir st 30 min. Shortening of treatment time significantly reduces the pain a nd discomfort experienced by the patient. Pretreatment parameters are not pre dictors of the pain level experienced. Copyright (C) 2000 S. Karger AG. Bas el.