J Urol. 1993 Nov;150(5
Pt 2):1591-6.
Transurethral
microwave thermotherapy for management of benign prostatic
hyperplasia: results of the United States Prostatron
Cooperative Study.
Blute ML, Tomera KM, Hellerstein DK, McKiel CF Jr, Lynch JH, Regan JB, Sankey
NE.
Department of Urology, Mayo Clinic, Rochester, Minnesota
55905.
The primary objective of the study was to determine the safety and
efficacy of transurethral microwave thermotherapy for the treatment of
symptomatic benign prostatic hyperplasia. From March
to August 1991, 150 patients were entered into a multi-site study and treated
with transurethral microwave thermotherapy under a Food and Drug Administration
approved protocol. Only patients with symmetrical trilobar
or bilobar prostatic hypertrophy,
peak flow rate of less than 15 cc per second (on 2 voided volumes of 150 cc or
greater) and a total Madsen symptom score of more than 8 were treated.
Transurethral microwave thermotherapy was performed with a 20F catheter and
1,296 MHz. microwave antenna for 60 minutes. The mean power achieved for this
single session was 32.1 watts, with a mean power at maximum urethral
temperature of 41.1 watts. Mean urethral temperature was 44.3C and the mean
rectal temperature was 42.2C. The rectal and urethral temperatures were
continuously monitored. Mean peak urinary flow rates, Madsen symptom score,
post-void residual volume and improvement in motivating symptom to seek
treatment were measured at 6 weeks, and 3, 6 and 12 months. Mean peak urinary
flow rates improved 33% at 12 months (p < 0.0001). Overall, the mean Madsen
symptom score improved 61% (p < 0.0001). The obstructive score and the irritative score improved 67% and 43%, respectively. Of 17
patients 12 (71%) reported improvement in weak stream when that was the
motivating symptom to seek treatment. Of 28 men 18 (64%) reported improvement
in nocturia, while 11 of 30 (37%) reported
improvement in daytime frequency and 12 of 17 (71%) reported improvement in
urgency. There was no statistically significant difference in post-void
residual volume at 12 months from baseline. The treatment was well tolerated by
all patients, and side effects were considered mild and transitory. Our study
demonstrates the safety, effectiveness, patient tolerability and durability of
transurethral microwave thermotherapy.
Publication Types:
* Clinical Trial
* Multicenter
Study