Comparison Between the Early and Late Results of Operative Therapy and Thermotherapy for the Benign Prostatic Hyperplasia

Byun, Chang Yul; Cho, Sung Ryong

Abstract

Alternative treatment modalities for benign prostatic hyperplasia(BPH) have during the last few years been introduced including transurethral microwave thermotherapy(TUMT). The aim of this presentation is to compare a new non-surgical treatment to a well-established surgical procedure(TURP, open prostatectomy) and to report our updated early 3 months and late mean 15 months results of this TUMT versus operative therapy in patients with BPH. From Sep.1992 to Aug.1993, 33 and 29 patients who was underwent TUMT and surgical procedure respectively with BPH in Taegu Fatima Hospital have been followed for early 3 months, 26 and 22 patients for late mean 15 months. 1 The two groups were almost identical regard to mean age, prostate volume, modified Boyarsky symptom score, maximal and mean flow rate (P>0.05). 2. The modified Boyarsky symptom score decreased significantly from 19.5 to 6.7, at 3 months and 8.5 at l5 months after surgical procedure and from 18.9 to 9.8 at 3 months and 14.7 at 15 months after TUMT respectively. The decrease was more pronounced after surgica1 procedure at 3 and 15 months (P<0.01). 3. The maximum flow rate increased significantly from 3.4 to 16.0 at 3 months and 14.9ml/ sec at 15 months after surgical procedure and from 4.0 to 9.2 at 3 months and 6.2mI/sec at 15 months after TUMT respectively. The increase was more pronounced after surgical procedure at 3 and 15 months (P<0.01). 4. The improvement degree of the early 3 months and late mean 15 months was not significantly decreased at the late 15 months after surgical procedure t>0.05), but significantly decreased at the late 15 months after TUMT(p<0.01) respectively. 5. The degree of satisfaction of the patients themselves with each prescription was 96.6% at 3 months and 87.0% at 15 months after surgical procedure and 66.7% at 3 months and 34.6% at 15 months after TUMT respectively. To conclude, significant improvements were observed in both groups with regard to symptom score, maximal and mean flow rate. The improvements in all regards were more pronounced after surgical procedure, and improvement degree was significantly decreased at the late 15 months after TUMT. Therefore, our study suggest that the clinical results in treating the BPH patients with TUMT will be better with the proper patients selection and retreatment in the decreasing point of treatment effectiveness.