Microwave thermotherapy for benign prostatic hyperplasia

Hoffman, Richard M.; Monga, Manoj; Elliott, Sean P.; MacDonald, Roderick; Langsjoen, Jens; Tacklind, James; Wilt, Timothy J

doi:10.1002/14651858.cd004135.pub2

Cited by 56 publications

(22 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This has mostly been driven by a decrease in thermotherapy. TUNA and TUMT have been traditionally viewed as lacking the long term therapeutic efficacy of TURP 7,9,18 . This decrease in rate of thermotherapy coincides with the increase in the utilization of laser vaporization.…”

Section: Resultsmentioning

confidence: 99%

National Trends in Surgical Therapy for Benign Prostatic Hyperplasia in the United States (2000-2008)

Malaeb

McBean

et al. 2012

Urology

151

View full text Add to dashboard Cite

Introduction The rate of utilization of thermotherapy and laser therapy in the surgical treatment of benign prostatic hyperplasia (BPH) has been changing over the past decade in conjunction with a steady decrease of TURP. We now report an update of the change in utilization trends for different surgical treatments of BPH among the United States Medicare population data 2000-2008. Methods Using the 100% Medicare carrier file for the years 2000-2008 we calculated counts and population-adjusted rates of BPH surgery. Rates of TURP, thermotherapy and laser-utilizing modalities were calculated and compared in relation to age, race, clinical setting, and reimbursement. Results After years of a steady rise, the total rate of all BPH procedures peaked in 2005 at 1,078/100,000 then declined by 15.4% to 912/100,000 in 2008. TURP rates continued to decline from 670 in 2000 to 351/100,000 in 2008. Rates of TUMT peaked in 2006 at 266/100,000 then declined 26% in 2008. Laser vaporization almost completely replaced laser coagulation and in 2008, was the most commonly performed procedure second to TURP with the majority performed as outpatient procedures (70%) and an increasing percentage in the office (12%). Men between ages 70-75 had the highest rate of procedures. Reimbursement rates correlate with the use of some but not all procedures. Racial disparities reported previously appear to have resolved. Conclusions Surgical treatment of BPH continues to change rapidly. TURP continues to decline and laser vaporization is the fastest growing modality. There is a big shift towards outpatient/office procedures. Reimbursement rates do not appear to have a consistent effect on utilization.

show abstract

Section: Resultsmentioning

confidence: 99%

National Trends in Surgical Therapy for Benign Prostatic Hyperplasia in the United States (2000-2008)

Malaeb

McBean

et al. 2012

Urology

151

View full text Add to dashboard Cite

show abstract

“…We could not examine trends in the use of transurethral microwave thermotherapy (TUMT) and transurethral needle ablation (TUNA) of the prostate, because the SASD and SID databases do not reliably capture these office based procedures. 6 However, TUMT and TUNA offer less durable results, 21,22 so a clinical decision for a patient with symptomatic LUTS first involves the decision for an operative versus office based procedure and then secondarily a decision for or against laser prostatectomy. Therefore, a comparison of laser prostatectomy and TURP more accurately reflects the real clinical decision-making process.…”

Section: Discussionmentioning

confidence: 99%

Population Based Trends in the Surgical Treatment of Benign Prostatic Hyperplasia

et al. 2012

View full text Add to dashboard Cite

Purpose Laser prostatectomy has increased in popularity over the last decade. However, traditional transurethral resection of the prostate (TURP) remains common. In an effort to understand decisions surrounding use of laser prostatectomy versus TURP, we evaluated trends in transurethral surgery for benign prostatic hyperplasia (BPH) in an all payer dataset, focusing on patient and provider factors that are associated with receipt of laser prostatectomy. Methods Using the State Inpatient and Ambulatory Surgery Databases for Florida, we identified subjects undergoing laser prostatectomy or TURP (2001 to 2009). We calculated rates of surgery over time, stratified by procedure type. We used multilevel regression to examine patient (age, race, level of comorbidity) and provider (surgeon volume) factors associated with receipt of laser prostatectomy versus TURP. Results While the overall rates of transurethral surgery remained stable (p=0.227) over the study period, use of laser prostatectomy rose 400% (from 25 to 114 procedures per 100,000 men, p<0.001), replacing about half of all TURPs. Patients were less likely to undergo laser prostatectomy if they were older (OR 0.65, 95% CI 0.61–0.70) and less healthy (OR 0.48, 95% CI 0.45–0.51). While these factors were predictive of surgery type, the majority of the variation in laser prostatectomy use (69%) was explained by the urologist a patient saw. Conclusions Laser prostatectomy utilization has increased over the last decade at the expense of TURP, driven largely by provider effects. However, the elderly and more infirm patients are the least likely to receive it, raising concerns about underuse in this population.

show abstract

“…35 Although associated with increased catheterisation time and urinary retention rate compared with TURP, TUMT had significantly lower hospitalisation time and rates of clot retention, blood transfusion, TUR syndrome and sexual dysfunction. 34 Twelve-month retreatment rates were significantly higher for TUMT (7.5%) than TURP (1.1%).…”

Section: Transurethral Microwave Therapymentioning

confidence: 86%

“…A Cochrane systematic review of TUMT found it improved the symptom score (65%) and Q max (70%) although this was inferior to TURP. 34 Initially, it was thought that urinary retention was a contraindication to TUMT due to post-procedure prostatic oedema; however, some success has been reported in the setting of retention. 35 Although associated with increased catheterisation time and urinary retention rate compared with TURP, TUMT had significantly lower hospitalisation time and rates of clot retention, blood transfusion, TUR syndrome and sexual dysfunction.…”

Section: Transurethral Microwave Therapymentioning

confidence: 99%

A review of surgery and new technology procedures for the management of benign prostatic obstruction

Morton

McGuiness

Harding

et al. 2019

Journal of Clinical Urology

View full text Add to dashboard Cite

show abstract

Microwave thermotherapy for benign prostatic hyperplasia

Cited by 56 publications

References 54 publications

National Trends in Surgical Therapy for Benign Prostatic Hyperplasia in the United States (2000-2008)

National Trends in Surgical Therapy for Benign Prostatic Hyperplasia in the United States (2000-2008)

Population Based Trends in the Surgical Treatment of Benign Prostatic Hyperplasia

A review of surgery and new technology procedures for the management of benign prostatic obstruction

Contact Info

Product

Resources

About