Pressure-Flow Study Analyses in Patients Treated with High Energy Thermotherapy

Abstract

Purpose: We evaluated the urodynamic changes after high energy microwave thermotherapy in patients with lower urinary tract symptoms and benign prostatic enlargement.Materials and Methods: A total of 120 patients was available for analysis with urodynamic investigation and pressure-flow studies before and 6 months after treatment. Several obstruction parameters were used to evaluate treatment outcome.Results: A significant decrease (p <0.001) in all obstruction parameters was noted. Mean detrusor pressure at maximum flow decreased from 64.7 to 39.1 cm. water, urethral resistance factor from 41,8 to 23.5 cm. water and linear passive urethral resistance relation from 3.0 to 1.4. Analysis of subgroups showed better results in patients with greater degrees of obstruction.Conclusions: High energy thermotherapy results in a significant and substantial decrease in bladder outlet obstruction.

Initial Experience with a New Transurethral Microwave Thermotherapy Treatment Protocol &lsquo;30&ndash;Minute TUMT&rsquo;

“…The lower energy TUMT has proven to be safe and well tolerated with only 15–25% of patients requiring temporary catheterization for an average of 5 days [14]. A second higher energy 1–hour protocol, TUMT 2.5, was introduced in 1993 [9, 10]. The magnitude of the clinical benefit was greatly increased: flow rate improvement was significantly greater and 60% of the patients were shown to be unobstructed by P/Q studies [16].…”

“…The initial algorithm used for TUMT was a low–energy protocol, mean power 40–50 W, such as Prostasoft TUMT 2.0, followed by a second higher energy, mean power 60–80 W, such as Prostasoft TUMT 2.5. However, the former showed a poor efficacy and the latter a high incidence of post–treatment side effects [9, 10, 11]. …”

A Randomized Study Comparing High&ndash;Energy TUMT to TURP: Quality&ndash;of&ndash;Life Results

“…TUMT has been shown to be a fairly effective, single–session, anesthesia–free, outpatient treatment modality [14, 15, 16, 17]. TUMT consists of microwave energy administered transurethrally, simultaneously providing radiative heat to the prostate and conductive cooling to the urethra.…”

High energy transurethral thermotherapy in the treatment of benign prostatic hyperplasia: criteria to predict treatment outcome

“…When evaluating the results of the higher energy protocol version, it seemed that the best responders were patients with moderate to severe outow obstruction and patients with larger prostates. 6,11,12 These results were obtained by stratifying patients in preselected cohorts without knowledge of the contribution of each individual baseline-parameter to therapy-outcome.…”