[Transurethral thermotherapy by microwaves in patients with benign obstructive prostatic hypertrophy].

The effect of transurethral microwave thermotherapy (TUMT) with Prostatron in patients with benign prostatic hypertrophy was investigated. Two hundred and one patients were treated between January 1991 and June 1992 after informed consent was signed. The following examinations were carried out at screening: interview (including symptoms score evaluation), physical examination (including digital rectal examination), haematology and blood chemistry (including prostate specific antigen), ECG, chest Xray, kidney, bladder and prostate (transrectal) ultrasound sonography (USS) and uroflowmetry; pressure-flow study was performed in a selected group of patients. All enrolled patients had Madsen symptom score > or = 8; peak flow rate < or = 15 ml/s and post void residual urine < or = 200 ml. Patients with obstructive middle lobe of the prostate, any BPH complication or any suspicion of prostatic carcinoma were excluded from the study. Microwave thermotherapy with Prostatron was carried out according to software generation 2.0 (Prostasoft 2.0), the c10 (black) catheter was used in all patients. Follow-up visits were scheduled at 1 week, 1, 3, 6, 12, 18 months after microwave thermotherapy. Overall short- and long-term morbidity rates were 6.09 and 2.73 per cent, respectively. At 12 months, Madsen score was found to be reduced from 11.7 +/- 4.78 to 4.43 +/- 3.30; maximum flow rate (Qmax) was increased from 8.91 +/- 4.20 to 13.20 +/- 4.86; post void residual urine (PVRU) was reduced from 131 +/- 17.6 to 67.40 +/- 34.50.(ABSTRACT TRUNCATED AT 250 WORDS

Transurethral microwave thermotherapy: Morbidity and complications [TERMOTERAPIA TRANSURETRALE A MICROONDE: MORBIDITA E COMPLICANZE]

Results of a phase II study evaluating safety, side effects and therapeutic activity of transurethral microwave thermotherapy in patients with symptomatic benign prostatic hyperplasia, are reported. 221 patients with Madsen symptom score >8, peak flow rate <15 ml/s and post void residual urine <200 ml were enrolled between January 1991 and April 1992. Microwave thermotherapy was carried out in a single outpatient session; up to 60 watts power output were delivered and urethral and rectal temperature alarms set at 44.5 and 42.5°C, respectively. Patient compliance to microwave thermotherapy was satisfactory and iv sedation was required in only one patient. Modest haematuria and urethrorrhagia occurred for a few hours in all patients, after treatment; clot retention, requiring bladder irrigation for 48 hours, occurred in 1 patient. A Foley catheter was positioned after treatment in 32 patients for acute urinary retention and withdrawn after 10.5 days, on average. Urinary tract infections occurred in 11 patients and were successfully treated. Retrograde ejaculation or stenosis of the ejaculatory ducts were observed in 2 out of 84 patients. At one year, Madsen symptom score decreased on average, from 11.80 ± 4.91 to 4.20 ± 4.41, peak flow rate increased from 8.89 ± 4.22 to 12.90 ± 3.75 ml/s, post void residual urine decreased from 132 ± 17.8 to 47 ± 41.4 ml/s. Transurethral microwave thermotherapy appeared to be, in our experience, a safe technique with negligible morbidity: therapeutic activity proved to be satisfactory in selected patients