Comparison of the Effect of Transurethral Thermal Therapy and Transurethral Resection of the Prostate for Benign Prostatic Hyperplasia

Moon, Du Geon; Kim, Je Jong

Abstract

It is accepted by urologists that transurethral resection of the prostate(TURP) is a golden standard in the treatment of benign prostatic hyperplasia( BPH). TURP is a safe procedure with low mortality rate but the rare, severe morbidity made the need for nonoperative treatment for BPH. Recently, non-invasive transurethral microwave hyperthermia has been applied as an alternative treatment of TURP. As a part of ongoing effort to evaluate the effect of transurethral microwave hyperthermia for BPH, we compared the outcomes of TURP with transurethral thermal therapy(TUTT). In 34 patients treated with TURP, the preoperative peak urine flow rate was 6.61ml/sec, but has changed to 14.33 and 14.64ml/sec at postoperative 4weeks and 6months respectively. The Boyarsky symptom score was 13.7 preoperatively, but has changed to 4.43 and 4.66 at postoperative 4weeks and 6months respectively Amount of residual urine was 91.35cc preoperatively. but has decreased to 40.7 and 40.32cc at postoperative 4weeks and 6months respectively. In 35 patients treated with TUTT. the preoperative peak urine flow rate was 9.24ml/sec, but has increased to 11.83 and 12.39ml/sec at postoperative 4weeks and 6months respectively. The preoperative Boyarsky symptom score of 12.9 has decreased to 8.58 and 8.97 at postoperative 4weeks and 6months respectively. The preoperative amount of residual urine was 52.45cc, but has changed to 44.74 and 35.2cc at postoperative 4weeks and 6months respectively. When comparing the parameters between two groups, the improvement of peak urine flow rate was greater in TURP than in TUTT group at postoperative 6months(p<0.01). The decreases of symptom score and amount of residual urine also were greater in TURP than in TUTT group, but not significantly different. In both group, no noticeable complications were encountered. These findings suggest that TURP is more effective than TUTT in the treatment of symptomatic BPH. But our data also raise the possibility that TUTT represents a safe outpatient approach to treatment of BPH, particularly for patients not considered to be candidates for conventional surgical treatments of BPH.