Transurethral Microwave Thermotherapy for Benign Prostatic Hyperplasia

Abstract

Since September 1990, 39 patients with symptomatic benign prostatic hyperplasia (BPH) have been treated by transurethral microwave thermotherapy (TUMT) using the Prostatron (Technomed International, France). The initial 31 patients were treated with the first-generation software (PROSOFT-1; maximum power up to 45 W), while the most recent 8 patients have been treated with the second-generation version (PROSOFT-2; maximum power up to 60 W). The efficiency and safety of this new treatment modality were evaluated in 37 of the 39 patients at the 8th week after TUMT. In order to examine the thermal effects on the prostatic tissue, transrectal MRI was performed in 10 patients with the use of a 1.5T endorectal surface coil. We found a significant improvement in subjective symptom scores (from 8.5 to 4.5 mean), as well as in maximum uroflow rates. The improvement of individual maximum flow rate, when expressed in changes of Siroky nomogram standard deviation, seemed to be dependent on the total microwave energy that could be applied to the prostate. The transrectal MRI study also confirmed that changes in the signals inside the prostate were clearly related to the thermal dose delivered to each gland. The treatment seems to be safe, because no serious adverse effects were observed, nor were there any significant changes in the immunological measures during the period examined.