Transrectal microwave hyperthermia for patients with benign prostatic hyperplasia.

BACKGROUND

A randomized study evaluated the efficacy of treatment with transrectal microwave hyperthermia (TMH) treatment in patients with benign prostatic hyperplasia (BPH).

METHODS

Eighty BPH patients received TMH therapy and 20 patients were given a sham treatment. TMH was achieved using a prostathermer which includes a microwave transrectal heat generator, a cooling system and a transurethral sensor probe. Patients that received TMH had 5 to 6 sessions of 1 hour each where the prostate was heated to 42 degrees C to 43.5 degrees C. The sham treatment consisted of a single session where the temperature was maintained at 37 degrees C. All patients were evaluated at 3 and 12 months after treatment.

RESULTS

There was an improvement of subjective obstructive symptoms in 54 patients (75%) after TMH. An evaluation of urodynamic parameters revealed an increase in the maximum flow rate and a decrease of the detrusor opening pressure as well as the detrusor pressure at maximum flow in patients treated with TMH. A significant improvement in the amount of residual urine was seen in all TMH-treated patients (P < 0.0001).

CONCLUSIONS

Although TMH cannot be considered a superior alternative to open surgical or transurethral excision of the prostate, it is a valid option for patients who have indwelling urethral catheters and for those at high surgical risk.