Transurethral Microwave Thermotherapy for Symptomatic benign Prostatic Hyperplasia: Long&amp;ndash;Term Durability with Prostcare

Tsai, Yuh Shyan; Lin, Johnny Shinn Nan; Tong, Yat Ching; Tzai, Tzong-Shin; Yang, Wen-Horng; Chang, Cheng-Chung; Cheng, Hong; Lin, Yung Ming; Jou, Yeong Chin

doi:10.1159/000052528

Cited by 18 publications

(7 citation statements)

References 19 publications

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“…Despite this promising discrepancy, d'Ancona et al [8] confirmed that the urodynamic change with high‐energy TUMT is still far from the results obtained with TURP. The need for re‐treatment is a crucial question in the management of BPH; with lower‐energy treatment it is common, with 50–85% of patients re‐treated within 3–5 years [12,21]. With higher energy TUMT, the re‐treatment rate appears to be less, at ≈ 20% within 3–4 years [22].…”

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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“…The incidence of retrograde ejaculation (33%) is increased with high-energy microwave thermotherapy compared with most low-energy thermotherapy studies, but this figure was still significantly lower than with TURP (63%) at 1 year in a randomized controlled study [17]. The increase was attributed to the greater tissue destruction with higher heat and possibly to increased bladder neck involvement [54]. Systems that treat the bladder neck have higher loss of ejaculate than those that do not involve the bladder neck [17].…”

Section: Transurethral Microwave Thermotherapymentioning

confidence: 93%

“…Depth of penetration varies depending on the microwave technology applied; it has been described as approximately 6 to 7 mm [53]. Erectile complications are generally low in most reviewed studies, with percentages of erectile dysfunction from 2% to 8% [51,[54][55][56]. Francisca et al [17] performed a randomized controlled study comparing sexual complications with TUMT and TURP.…”

Section: Transurethral Microwave Thermotherapymentioning

confidence: 99%

Sexual complications of minimally invasive surgical therapy for benign prostatic hyperplasia

Лебед

Jaffe²,

Te³

2006

Current Sexual Health Reports

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Benign prostatic hyperplasia (BPH) is a common disease process involved in aging, which can have a substantial impact on quality of life. Recently, there has been an increased focus on the correlation of lower urinary tract symptoms from BPH with sexual dysfunction. Multiple studies have implicated these symptoms as a risk factor for erectile dysfunction, ejaculatory dysfunction, and decreased libido. Invasive surgical prostate therapies also have been associated with erectile and ejaculatory dysfunction. Minimally invasive surgical therapies have been developed not only to alleviate symptoms that affect quality of life but also to reduce complications associated with standard surgical therapy, including adverse effects on sexual function. With the increased emphasis placed on sexual function and the greater level of concern expressed by patients, it is necessary to evaluate treatment modalities for their effect on erectile and ejaculatory function. This review focuses on the sexual outcomes of minimally invasive prostate therapies, especially with regards to erectile dysfunction and ejaculatory dysfunction, and the impact of these therapies on quality of life.

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“…At 5 years after TUMT with the Prostasoft 2.0, 41% of the patients had received instrumental retreatment, and 17% were being retreated with medication. 16 More recent studies [17][18][19] confirm the limited durability of clinical outcome obtained by lower-energy programs, with a retreatment rate as high as 84.4% after 5-year follow-up.…”

Section: Durabilitymentioning

confidence: 93%

Application of External Microwave Thermotherapy in Urology: Past, Present, and Future

Gravas

Laguna

Rosette

2003

Journal of Endourology

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The excellent clinical results of transurethral microwave thermotherapy (TUMT) for the treatment of symptomatic benign prostatic hyperplasia (BPH) gave to TUMT the leading position among the microwave thermotherapy modalities available for the treatment of different urologic conditions. Research in TUMT has focused on operating software, temperature monitoring, intraprostatic heat distribution, cell-kill calculations, and correlations with clinical variables. Randomized comparisons of TUMT with other established therapies for BPH, including transurethral resection, have facilitated the evaluation of the clinical outcome, durability, morbidity, and costs of the treatment. The applications of microwave thermotherapy in other urologic diseases are also presented in this review.

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Transurethral Microwave Thermotherapy for Symptomatic benign Prostatic Hyperplasia: Long–Term Durability with Prostcare

Cited by 18 publications

References 19 publications

High‐energy transurethral microwave thermotherapy: symptomatic vs urodynamic success

High‐energy transurethral microwave thermotherapy: symptomatic vs urodynamic success

Sexual complications of minimally invasive surgical therapy for benign prostatic hyperplasia

Application of External Microwave Thermotherapy in Urology: Past, Present, and Future

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