Effect of Transurethral Microwave Thermotherapy

Nordenstam, Gunnar; Aspelin, P.; Isberg, B.; Svensson, L.; Hallin, Anders; Berlin, Tomas

doi:10.3109/02841859609175472

Cited by 5 publications

(2 citation statements)

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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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Section: Discussionmentioning

confidence: 99%

High‐energy transurethral microwave thermotherapy: symptomatic vs urodynamic success

et al. 2003

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“…One suggested explanation to this discrepancy is the use of equipment with completely different heat patterns [46]. Earlier clinical studies have shown that the success rate is highly correlated with the power transmitted to the tissue [47]. However, numerous sham studies have shown a beneficial reduction of symptoms [48][49][50][51][52], supporting further use of TUMT.…”

Section: Microwave Energy Evaluation and Improvement Of The Tumt Tecmentioning

confidence: 99%