Transurethral microwave thermotherapy for symptomatic benign prostatic hyperplasia: Long-term durability with Prostcare

Objective: To evaluate the long-term durability of transurethral microwave thermotherapy (TUMT) with Prostcare for symptomatic benign prostatic hyperp lasia (BPH). Patients and Methods: From August 1993 to July 1994, a total of 65 patients with symptomatic BPH who underwent TUMT using the Prostcare apparatus (Bru ker Spectospin, Wissembourg, France) with low-energy protocol (maximal powe r 52 W) were enrolled into a short-term evaluation. Subsequent follow-up in formation was collected in July 1999. If patients had had any further thera py for BPH, the date of retreatment was considered as an endpoint of TUMT e fficacy. If no further therapy for BPH had been needed, they were re-assess ed for overall satisfaction. Results: The median follow-up period was 49 months. Twenty patients were ex cluded for various reasons, including 17 with loss of follow-up and 3 with new diseases that could affect the voiding status. Thirty-eight (84.4%) of 45 valuable patients had received further therapy for BPH, including medica tion (n = 21, 46.7%), and endoscopic surgery (n = 17, 37.7%). The times to pharmacologic or endoscopic retreatment after TUMT were 8.9 +/- 11.1 and 23 .0 +/- 14.4 months, respectively (p = 0.0003, log rank test). Only 7 (15.5% ) patients had no further treatment, with 3 having satisfactory improvement s, but 4 feel dissatisfied yet not needing any further therapy. In addition , 2 patients complained of erectile dysfunction after TUMT and 1 was diagno sed with prostate cancer 50 months after TUMT. In addition, there was no si gnificant difference for all baseline values among three groups with no ret reatment or retreatment with medication or endoscopic surgery. Conclusion: At the 5-year follow-up, the long-term durability of low-energy TUMT with Prost-care is only exhibited in a few patients and the overall r etreatment rate was 84.4%. Thus, patient should be informed of the high pro bability of supplementary treatment after TUMT. Copyright (C) 2001 S. Karge r AG, Basel.