The Clinical Effects of Transurethral Microwave Thermotherapy in Case of Benign Prostatic Hyperplasia with Urinary Retention

Lee, Chun Gu; Kim, Ho Sung; Rim, Joung Sik

Abstract

From February, 1993 to April, 1994, 32 benign prostatic hyperplasia( BPH) patients with urinary retention were treated with transurethral microwave thermotherapy(TUMT). The mean patient age was 74 years(range 59 to 86 years) and the mean duration of retention was 3.7 months(range 1 day to 36 months). The mean follow-up period was 13 months (range 4 to 18 months). In cystoscopic findings, trilobar hyperplasia was diagnosed in 12 patients(37% ), while bilobar and median bar or median lobe enlargement were diagnosed in 11 patients(35% ) and 9 patients( 28% ). Mean prostatic weight was 29gm(range 11.3 to 89.5gm) Of the patients 14(44% ) patients were in the catheter-free state( = Responder) after TUMT and 18(56%) patients had to be in the catheter-indwelling state( = Nonresponder). The 14 responders showed several important parameters: mean peak flow rate was 8.9ml per second ( range 4.5 to 17.5ml per second), mean post-voiding residual urine was 137.5ml( range 80 to 220ml) and a mean symptom score was 10.7 on the modified Boyarski symptom score scale. Also, there was no significant difference in the incidence of catheter-free state in patients with bilobar and trilobar hyperplasia compared to those with median bar or median lobe hyperplasia. Conclusively, one session of TUMT at 50 degrees C for 90 minutes seemed to have minor therapeutic effect on BPH patients with urinary retention. Therefore, the clinical results in treating the BPH patients with urinary retention suggest that the more clinical experiences will be needed about the proper patient selection, the safety introduction of higher temperature, the prolonged treatment time and the numbers of treatment session.