High-energy transurethral microwave thermotherapy: A thermoablative treatment for benign prostatic obstruction

被引:54
作者
deWildt, MJAM
Debruyne, FMJ
delaRosette, JJMCH
机构
[1] Department of Urology, University Hospital Nijmegen, Nijmegen
[2] Department of Urology, University Hospital Nijmegen, 6500 HB Nijmegen
关键词
D O I
10.1016/S0090-4295(96)00189-6
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Objectives. High-energy transurethral microwave thermotherapy (TUMT) was developed to increase treatment efficacy over former low-energy treatment protocols as an outpatient-based, anesthesia-free procedure for patients with benign prostatic obstruction. A Phase II study was conducted to evaluate treatment outcome and to enlighten possible prognostic factors. Methods. Eighty-five patients with lower urinary tract symptoms were included in the study, A Madsen symptom score of 8 or more, a maximum flow less than 15 mL/s, and a postvoid residual urine volume (PVR) of under 350 mL were the main requirements for entry. Results. Eleven patients were lost to follow-up, making 74 patients evaluable at 1-year follow-up. Significant improvement was noticed in all indices: the Madsen symptom score improved 58% from baseline; the maximum flow rate improved from 9.4 to 14.9 mL/s, with a decrease in PVR of 80 mL to 25 mL; bladder outlet obstruction could be relieved in 78% of patients; and prostate volume decreased by 20%, with cavity formation in 42% of patients. Patients with bigger prostates (greater than 40 cm(3)) and patients with more severe bladder-outlet obstruction appeared to be the best responders. Post-treatment morbidity consisted of a prolonged need for transurethral catheter drainage (mean 16 days), with correlated irritative voiding complaints for an average of 2 to 3 weeks. Conclusions. Overall improvement of high-energy thermotherapy now shows comparable results to surgical resection of the prostate.
引用
收藏
页码:416 / 423
页数:8
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