Transurethral Microwave Thermotherapy(TUMT): A Non-surgical Alternative for the Treatment of Benign Prostatic Hyperplasia(BPH)

Lee, Dong Han; Cho, Yong Hyun; Yoon, Moon Soo

Abstract

Transurethral microwave thermotherapy is being investigated as an alternative treatment for relief of bladder outlet obstruction in patients with benign prostatic hyperplasia. TUMT is a single one hour session, utilizing only topical anesthesia and carried out on an ambulatory basis. The prostatron is a unique microwave device which allows temperatures in excess of 45'C to be achieved within the prostate. When this temperature is maintained for 60minutes, benign tissue is irreversibly affected. Since October 1992, 353 patients have been treated. Patients ranged in age from 49 to 86 years, the mean age being 64.5 years. All patients had a clinical history, digital rectal examination of prostate, KUB films, modified Boyarsky symptom score, peak urinary flows, urinalysis, prostatic specific antigen, postvoid residuals and prostate volume determined by transrectal ultrasound. Prostate ranged from 15 grams to 79 grams. the mean being 33.8 grams. 207 patients have been followed for a period of 3 months post treatment, 133 patients for a period of 6 months and 96 patients for a period of 9 months. The modified Boyarsky symptom score decreased from 13.9 to 8.3, 8.6 and 9.7 respectively. The peak flow rate increased significantly from 7.8 to 11.8, 12.0 and 11.7 ml/sec respectively. The residual urine volume decreased from 81.3 to 37.1, 34.8 and 36.2 respectively. 6 patient received TURP due to the failure of treatment or recurrence of the symptoms. In conclusion, both symptoms and obstruction caused by BPH could be addressed by thermotherapy as an anesthesia-free, non-surgical alternative. More investigation will be necessary to know long-term effectiveness of TUMT.