Transurethral microwave thermotherapy

Objectives and Methods: The present status of transurethral microwave thermotherapy (TUMT) in the low (LE) and high energy (HE) version is given as an overview. Results: With LE software, approximately 75% of patients will note significant improvement with 65% reduction in symptom scores and a 35-40% improvement in peak flow rate. Sham studies have shown statistically significant improvement in treated patients compared to sham. Randomized studies between TUMT and TURF show similar improvements in symptom scores with TURF producing higher flow rates, as expected. Longterm studies have been reported to 5 years showing durability, although 10-20% of patients subsequently undergo TU RP. The clinical efficacy of HE-TU MT 2.5 has been documented in recently completed studies. Approximately 37% of patients develop cavitation with HE-TUMT. The symptomatic improvement is similar between low and high energy while the flow rates with high energy improve by approximately 65%. Pressure flow studies have documented relief of obstruction in most of those patients who had obstruction prior to treatment. The morbidity of HE-TUMT in terms of retrograde ejaculation and posttreatment retention is higher compared to the LE version. Conclusions: TUMT is a 1-hour outpatient, local anesthetic procedure, minimally invasive treatment option for benign prostatic hyperplasia that encompasses microwave radiative heating and water conductive cooling. TUMT has been proven both safe and efficacious for relieving benign prostatic hyperplasia symptoms in several large-scale controlled studies. The existence of low and high energy versions offers the opportunity to select patients according to obstruction grade.