Transurethral microwave thermotherapy for benign prostatic hyperplasia

Abstract

Transurethral resection of the prostate (TURP) remains the gold standard for treatment of benign prostatic hyperplasia (BPH). In general, while this procedure is safe, patients require a spinal, epidural, or general anesthesia and often several days of hospital stay; the potential morbidity and mortality limits the use of TURP in high-risk patients. Pharmacotherapy has been recommended as a first-line therapy for all patients with mild to moderate symptoms. Patients are often times enthusiastic if they are offered a one-time method to treat lower urinary tract symptoms secondary to BPH, provided that the method offers reduced risk and allows an efficacy equal to that of medical therapy. One such method is transurethral microwave thermotherapy (TUMT). TUMT involves the insertion of a specially designed urinary catheter with a microwave antenna, which heats the prostate and destroys hyperplastic prostate tissue. TUMT allows the avoidance of general or regional anesthesia, and results in minimal blood loss and fluid absorption. In this review, the authors discussed the current indications and outcome of TUMT, including the history of the procedure, the mechanism of action, the indications for TUMT, the pre-operative considerations, the patient selection, the results in terms of efficacy, by comparing TUMT vs. Sham, TUMT vs. Alpha-blocker and TUMT vs. TURP. Finally, the complications are presented, as well as other uses and future directions of the procedure. The authors concluded that TUMT is a safe and effective minimally invasive alternative to treatment of symptomatic BPH.

Transferrin as a thermosensitizer in radiofrequency hyperthermia for cancer treatment

“…Electromagnetic waves such as X-ray, red light, microwave and radiofrequency wave are widely used in modern medicine for various therapeutic purposes (Table 2 ). Although use of X-ray and red light is limited to cancer treatment 34 – 39 , microwave and radiofrequency have been broadly used for therapeutic purposes in modern medicine as in the cases of cancer treatment 40 , infectious disease treatment 41 , spinal cord repair 42 , enlarged prostate treatment 43 – 45 , etc 46 . However, unlike X-ray and red light, a sensitizing agent for microwave and radiofrequency has not been developed.…”

“… 39 Microwave 1 × 10 6 ~1 mm None Cancer Rubeinstein, et al . 40 Radiofrequency 1 mm~100 km None Cancer, infectious disease, spinal cord injury, enlarged prostate, etc Sadeghian et al . 41 , Akkoc, et al .…”

Transuretrinės mikrobangų termoterapijos ankstyvieji ir vėlyvieji rezultatai gydant nepiktybinę prostatos hiperplaziją

“…Gydymo metodas grástas mikro-bangø poveikiu prostatos audiniui. Nuo 1982 m. NPH gydyti termoterapija pradëta naudoti kaip transuretrinës prostatos rezekcijos (TURP) alternatyva [2].…”

“…Ið pradþiø TUMT buvo taikoma tik gydant ryðkius ðlapinimosi sutrikimo simptomus ar esant rizikai sukelti nejautrà ir operuoti [4,5]. Taèiau dabar indikacijos yra platesnës, nes ligoniai daþniau pageidauja minimaliai invazyvaus gydymo, be to, galima gydytis ambulatoriðkai, nereikia ilgai gulëti ligoninëje, atliekama tik minimali anestezija, greitai sveikstama [2].…”

“…Literatûroje pateiktose studijose yra ávertinta prostatos hiperplazijos simptomatika, paskelbti penkeriø metø laikotarpio gydymo rezultatai. Geriausi rezultatai yra pirmaisiais ir antraisiais metais po termoterapijos [2]. G. N. Thalmann, F. C. d'Ancona, M. A. Robinette duomenimis, stabilus simptominis ir urodinaminis pagerëjimas iðliko dvejus metus, paskui buvo NPH simptomø recidyvø [7,8,13].…”