Intra-prostatic vasculature studies: Can they predict the outcome of transurethral microwave thermotherapy for the management of bladder outflow obstruction?

BACKGROUND. Blood perfusion regulates intraprostatic temperatures during tr ansurethral microwave thermotherapy (TUMT). We evaluated baseline intrapros tatic vasculature, as a predictor of efficacy of TUMT. METHODS. Twenty-two patients, with lower urinary tract symptoms (LUTS) sugg estive of bladder outflow obstruction, were treated with TUMT (Prostatron). At baseline, three-dimensional contrast-enhanced power-flow-Doppler prosta te ultrasonography (3D-CE-PFD) was performed. Assuming that the percentage of perfused area (PPA) is a realistic measure of blood flow, it was used to quantify intraprostatic vasculature. RESULTS. The median (range) age, prostate size, and energy delivered were 6 6 years (48-80), 47 cm(3) (30-121), 110 kJ (29-136), respectively. The resp onse was 77% (5 failures). The median (range) PPA was 2.76% (0.7-11.3). No difference in PPA among good and poor responders was detected nor was any c orrelation between PPA and baseline parameters. CONCLUSIONS. The baseline intraprostatic vascularization, documented by CE- PFD studies, has no predictive value for the efficacy of TUMT. It seems tha t "static" baseline blood flow does not reflect the "dynamic" thermoregulat ory role of blood flow during treatment. (C) 2001 Wiley-Liss, Inc.