Transurethral radiofrequency thermotherapy for symptomatic patients with benign prostatic hyperplasia (bph): two year follow-up

A total of 132 patients with symptomatic BPH were treated in a single session with transurethral radiofrequency thermotherapy (TURT) using Thermex-ll (47.5 c.150 minutes) from November 1992 to April 1994. 88 patients who were available to follow-up for more than 6 months after TURT were enrolled into this study. 65 patients were available to follow-up for more than 2 years. To determine the long-term efficacy of TURT, the baseline and post-treatment mean symptom score(Madson-lversen), maximum flow rate (MFR), residual urine volume, and prostate volume were compared and the values at baseline were 15.1, 6.3 ml/sec., 51.3 ml, and 33.7 rnl, respectively. Improvement was defined as a reduction of more than 50% in at least one of two parameters symtom score and MFR). At 3 months follow-up, improvement was observed in 63.6%(56/88), and at 6 months 54.5% (48/88). However, improvements in both symtom score and MFR at 3 and 6 months aftertreatment were only 27.2% and 20.5%, respectively. Sixty five patients available to follow-up for more than 2 years were analyzed. Twenty seven patients (30.7%) had undergone transurethral resection of prostate and 28 patients (31.8%) received medical therapy such as alpha blocker during the last two years after TURT. The post-treatment values of 10 patients who did not receive surgical or medical therapy were 16.4 in mean symptom score, 7.1ml/sec in MFR, 68,2ml in postvoiding residual urine volume, and 29.1 ml in prostate volume, respectively. These values were very similar to those at baseline. Although thermal treatment for BPH is an alternative option with minimal complication in select symptomatic patients who are not clear candidates for surgery or who are high-risk patients, the effect of TURT is net sufficient to relieve the obstructive and irritative symptoms of BPH.