Transurethral microwave thermotherapy of benign prostatic hyperplasia: do any pretreatment conditions predict the result?

Abstract

To investigate the long-term effect of transurethral microwave thermotherapy (TUMT) treatment and find possible predictors of a favourable outcome. Men with symptomatic benign prostatic hyperplasia (BPH) (n = 339) were examined before undergoing TUMT. The pretreatment evaluation included two or more of the following: cystoscopy, ultrasonic examination of the prostate, urine flow rate, residual urine volume and Madsen symptom score. The urodynamic measurements and Madsen score were repeated after 3, 6 and 12 months. Six different groups, based on pretreatment examinations or energy given during TUMT, were analysed. The Madsen score was significantly reduced and the score reduction was similar in all groups. Residual urine did not change significantly and flow rate increased only marginally. At 12 months, 56% of the men were satisfied with the treatment result, 29% had received additional treatment because of insufficient relief symptoms, while the remaining 15% were not satisfied but decided not to undergo further treatment at present. The reduction in the Madsen score remained stable during 1-year follow-up. None of the investigated pretreatment findings were predictive of a favourable treatment result. Since TUMT did not increase peak urinary flow significantly, men with BPH symptoms and unobstructed micturition appear to be the most suitable group for treatment. This group of men showed the same symptomatic improvement as the other investigated groups.