Microwave thermotherapy: a long‐term follow‐up of 67 patients from a single centre

Abstract

Objective To determine the long‐term therapeutic value of transurethral microwave thermotherapy (TUMT) in the treatment of bladder outflow obstruction secondary to benign prostatic hyperplasia (BPH). Patients and methods A total of 67 patients with BPH, assessed using symptom scores and measurements of urinary flow rate, underwent TUMT using the Leo Microthermer system (Laser Electro Optics Ltd, London, UK) between October 1990 and June 1992. Follow‐up information was obtained on 60 patients (90%). If they had undergone no further treatment for their BPH, they were re‐assessed with symptom scores and measurements of flow rate. Results The mean follow‐up was 52.4 months; eight of the 67 patients had died and seven were lost to follow‐up. Sixteen of the remaining 52 (31%) had undergone another treatment for BPH; one patient developed prostatitis and one developed localized carcinoma of the prostate. Thirty‐four patients had had no further treatment, 29 of whom attended for assessment. In these patients, a statistically significant improvement in both the symptom score and flow rate was maintained at 4 years. No patients developed retrograde ejaculation. Conclusion This is the first study to report a follow‐up of at least 4 years after TUMT with any device. Treatment with the Leo Microthermer provided at least a 50% symptomatic improvement in 16 of 50 patients treated at 4 years. However, 30% of the patients needed further treatment for their BPH. TUMT is safe and effective in patients not wanting anaesthesia and in young patients concerned about retrograde ejaculation.

Durability of Results Obtained with Transurethral Microwave Thermotherapy in the Treatment of Men with Symptomatic Benign Prostatic Hyperplasia

“…20.0 (150) 9.0 (772) 5.9 (55) 5.6 (208) 13 10.1 (55) 9.7 (32) 9.1 (305) 7.9 (67) 9.6 (85) 9.5 (359) 8.4 (145) 10.9 (659) 10.5 (40) 11.4(228) 11.1 (58) 15.3 (284) 12.2 (123) 11.4(282) 11.9(175) 11.8 (113) 11.2(110) 11.9(63) 14.0 (202) 11.8 (103) 9.7 (37) 13.9 (149) 11.6 (67) 8.2 (45) 12.8 (32) 11.6 (29) 14.2 (89) 12.6 (28) 11.1 (37) 11.4 (89) 11.4 (21) of the technologies competing with TURP, long-term data are lacking. Of these competing technologies, the most extensive and longest experience has been with TUMT.…”

Transurethral Microwave Thermotherapy in the Management of Lower Urinary Tract Symptoms from Benign Prostatic Obstruction: Follow-up after Five Years

“…Few studies exist on more than 3 years of follow-up; Glass et al (9), using the Leo Microthermer system, recently reported !50% symptomatic improvement in 16 of 50 patients at 4 years, concomitant with a rate of additional treatment of 30%. Keijzers et al (10), using the Prostatron device with lower power protocol (Prostasoft 2.0), reported an overall retreatment rate of 58% within 5 years (invasive procedures in 41% and pharmacotherapy in 17%).…”

“…Numerous studies are available on the short-term effects of TUMT; for review see (5). Long-term data have been less frequently reported (6)(7)(8)(9)(10). This study used the PRIMUS U R device, which works within the lower power range (11), and extends the authors' short-term data (12,13) to include a full 5-year follow-up.…”

Medium-term efficacy of the prostatic urethral lift

“…The loss to follow-up of 23% of study participants at 4 years in the LIFT study is similar to the loss to follow-up numbers seen by investigators in the Veterans Affairs Cooperative study of TURP in which 18% were lost to follow-up at the 3-year visit (18). In studies investigating TUMT loss to follow-up at equivalent time points was 30% (19) to 35% (20) while a study of TUNA reported loss to follow-up of 62% at 4 years (21). The longest prospective study for BPH surgery (TURP) followed patients for ten years, only 41% were available for follow up (22).…”