Effect of Transurethral Microwave Thermotherapy

Nordenstam, Gunnar; Aspelin, Peter; Isberg, Bengt; Svensson, Leif; Hallin, Anders; Berlin, Tomas

doi:10.1177/02841851960373p298

Cited by 4 publications

(2 citation statements)

References 8 publications

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“…The mechanism of TUMT comprises a coagulative necrosis of prostate tissue, which is later absorbed due to an inflammatory process of healing and shrinkage. Nordenstam et al [11] did not find considerable intraprostatic necrosis in their patients after treatment with lowenergy TUMT. However, several studies [12Á14] using high-energy protocols and ultrasound assessment of prostate size have described a significant reduction in prostate volume, ranging from 14% to 30%, at 6 months after TUMT.…”

Section: Discussionmentioning

confidence: 70%

Transurethral microwave thermotherapy of the prostate – Evaluation with MRI and analysis of parameters relevant to outcome

Veselý

Müller

Knutson

et al. 2008

Scandinavian Journal of Urology and Nephrology

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Section: Discussionmentioning

confidence: 70%

Transurethral microwave thermotherapy of the prostate – Evaluation with MRI and analysis of parameters relevant to outcome

Veselý

Müller

Knutson

et al. 2008

Scandinavian Journal of Urology and Nephrology

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“…MRI of the prostate soon after TUMT was particularly useful as it clarified the effect of TUMT on the prostate. Nordenstam et al [23] showed that low‐energy TUMT induce only an increase in the T2‐weighted signal, with no evidence of necrosis. However, a well‐defined area of perfusion defect in the central zone of the prostate on enhanced T1‐weighted images is a constant feature after high‐energy TUMT [24].…”

Section: Discussionmentioning

confidence: 99%

High‐energy transurethral microwave thermotherapy: symptomatic vs urodynamic success

et al. 2003

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RESULTSAll patients completed at least 1 year of follow-up after TUMT as monotherapy. The symptom score improved from a median (range) of 20.5 (11-28) initially to 9 (0-28) ( P < 0.001). Twenty-two patients (55%) had a marked and 11 (28%) a moderate response, giving an overall subjective success rate of 83%. Similarly, there was a significant improvement in peak flow rate, from 9.2 (4.4-13.4) to 15 (3.3-22.9) mL/s ( P < 0.001). Twenty-one patients (53%) had a maximum flow rate of > 15 mL/s while in eight (20%) it was 10-15 mL/s. Only 20 patients changed from unobstructed on the pressure-flow nomogram, i.e. an overall objective success rate of 50%. Gadolinium-enhanced T1-weighted MRI 1 week after treatment showed a median (range) perfusion defect of 20.7 (5.5-76.6)% of the total gland volume. Despite this persisting in all patients, a welldefined cavity was apparent in only in seven (18%) at the final evaluation. Cystoscopy 1 month after therapy showed evidence of necrotic tissue occupying the prostatic fossa in all patients. Younger patients were more likely to be urodynamically successful, and a higher grade of obstruction predicted symptomatic success. CONCLUSIONHigh-energy TUMT can induce considerable necrosis of the prostate, as shown by MRI and cystoscopy. Although there was an adequate improvement in most patients' symptoms, there was a successful urodynamic change to unobstructed in only half the patients. Younger patients and those with a higher grade of obstruction were more likely to have urodynamic and symptomatic success, respectively.

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Minimally Invasive and Endoscopic Management of Benign Prostatic Hyperplasia

Fitzpatrick¹

2012

Campbell-Walsh Urology

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Effect of Transurethral Microwave Thermotherapy

Abstract: The study does not support the view that TUMT leads to significant necrosis in the prostate with loss of tissue and retraction. We theorize that the response to TUMT may be caused by a denervation of the prostate.

Cited by 4 publications

References 8 publications

Transurethral microwave thermotherapy of the prostate – Evaluation with MRI and analysis of parameters relevant to outcome

Transurethral microwave thermotherapy of the prostate – Evaluation with MRI and analysis of parameters relevant to outcome

High‐energy transurethral microwave thermotherapy: symptomatic vs urodynamic success

Minimally Invasive and Endoscopic Management of Benign Prostatic Hyperplasia

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