The 2-year symptomatic and urodynamic results of a prospective randomized trial of interstitial radiofrequency therapy vs transurethral resection of the prostate

Objective To assess the 2-year symptomatic and Urodynamic results of a pros pective randomized trial of interstitial radiofrequency therapy of the pros tate (IRFT) vs transurethral resection of the prostate (TURP). Patients and methods Patients with lower urinary tract symptoms (LUTS) and Urodynamic evidence of bladder outlet obstruction (BOO) were randomized to undergo IRFT or TURP and were followed up using the International Prostate Symptom Score (IPSS) and urodynamic assessment for 2 years. Results At 2 years there was a clinically relevant reduction in the IPSS in the IRFT (20 to 9) and TURP groups (22 to 4). There was also a statistical ly significant reduction in the detrusor pressure at maximum urinary flow i n both groups, but the reduction in the IRFT group was probably not suffici ent to explain the observed symptomatic improvements solely from it reducti on in BOO. Conclusion IRFT can produce a sustained improvement in LUTS for at least 2 years. However, such improvements arc unlikely to be entirely the result of a reduction in BOO. The effects of radiofrequency energy may. at least par tly, be independent of any thermal effect and depend instead on neuromodula tion of lower urinary tract nerves.