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Satisfactory results were obtained after both treatments, with improvements following high energy microwave thermotherapy being in the same range as those after transurethral resection of the prostate.

Since 1993, we have treated patients having lower urinary tract symptoms and benign prostatic obstruction using the high-energy transurethral microwave thermotherapy (HE-TUMT) protocol (Prostasoft; software version 2.5). This study was conducted to investigate the outcome and durability of this treatment. A series of 301 patients with a mean prostate size of 56.4 cc were treated by HE-TUMT if they had a Madsen Symptom Score > or = 8, a maximum flow rate < 15 mL/sec, a voided volume > or = 100 mL, and a postvoiding residual volume < 350 mL. The prostate volume measured by transrectal ultrasonography was > or = 25 cc. Follow-up visits were scheduled at 12, 52, 78, and 104 weeks. Patients were stratified according to the response evaluation criteria set at the 3rd International Consultation on Benign Prostatic Hyperplasia. These response criteria were measured at 12 weeks. At 2 years, there appeared to be a better response in the bigger prostates. Irrespective of relief of outflow obstruction, a good symptomatic response was seen in both good and poor responders. Twenty-two patients were re-treated during the 2-year follow-up period: three underwent bladder neck incision, nine transurethral resection, two laser prostatectomy, one open prostatectomy, and seven additional medical therapy. At 2-year follow-up, HE-TUMT resulted in a durable good outcome in 93% of patients with an objective improvement rate of 42% and a subjective improvement rate of 65%. The best predictor of durability appeared to be the extent of relief of obstruction. Of the 96 bad responders in this group, 14 underwent retreatment, compared with 6 of the 100 good responders.

At 5 years after transurethral microwave thermotherapy 41% of the patients received instrumental treatment. Patients with a lower Madsen score and lower residual volume, and those with higher peak flow and age were somewhat better responders to lower energy transurethral microwave thermotherapy.

The purpose of the present study was to evaluate the long-term results of lower-energy transurethral microwave thermotherapy (TUMT) and to determine predictors for a favorable treatment outcome in an international multicenter study. A total of 1092 patients treated between April 1990 and September 1993 in 6 different centers in different countries were evaluated. All patients were treated in a nonblinded, noncontrolled fashion with the Prostatron thermotherapy device using the lower-energy treatment protocol Prostasoft 2.0. Collected data included voiding parameters, Madsen symptom scores, retreatments, types of retreatment, and dates of retreatment. Instrumental retreatment served as the end point for further evaluation. The average age of our patients was 67 years. At baseline the average uroflow rate was 8.7 ml/s. After treatment the improvement in uroflow was 2-3 ml/s. This was maintained for up to 5 years after treatment for the patients remaining in follow-up. The overall improvement in the Madsen symptom score was 5-6 points for these patients. There was no significant difference between the different centers. During follow-up, however, the number of patients remaining in follow-up decreased rapidly. The absolute instrumental retreatment rate appeared to be 26%; however, when patients no longer in follow-up were taken into account, the calculated retreatment rate was 39.6% (Kaplan-Meier survival analysis). Patients undergoing retreatment were younger at baseline and had a higher Madsen score, a bigger prostate, and a greater postvoid residual. No major complication was seen. Lower-energy TUMT gives a sustained objective and subjective improvement in patients with moderate symptoms and a low-grade bladder outflow obstruction. Patients with bigger prostates, severe symptoms, low rates of maximal uroflow, and large residuals are prone to have a higher degree of prostatic obstruction and are not the ideal candidates for this treatment. The absolute instrumental retreatment rate after 5 years was 26%. Moreover, no significant international difference in treatment outcome was found.

Purpose: A retrospective study was done to investigate the long-term outcome of patients treated with lower energy transurethral microwave thermotherapy. Materials and Methods: A total of 305 patients with lower urinary tract symptoms and benign prostatic hypertrophy underwent transurethral microwave thermotherapy according to a similar protocol at 2 centers. Results: After 3 years of followup 133 patients who had undergone transurethral microwave thermotherapy alone were available for study. During this observation period significant symptomatic improvement from baseline and an improved maximum flow rate of 2.6 ml. per second were noted. Of the patients 125 underwent invasive or medical treatment. Conclusions: After 3 years of followup lower energy transurethral microwave thermotherapy showed significant and durable improvements in baseline parameters in 52% of the patients.

No abstract

Objective To evaluate the combination of patient age,Results Nomograms are presented providing the estimated probability (95% confidence interval) for a prostate size, grade of outlet obstruction and total amount of energy, all independent predictive variables good/ 50% [3,4]. These objective and subjective improvements