A Comparative Study on the Clinical Outcomes of Bipolar Radiofrequency Thermotherapy Versus Transurethral Resection of the Prostate in Storage Symptoms Associated With Benign Prostatic Obstruction

Abstract

Purpose: The aim of the study was to compare the results of radiofrequency (RF) thermotherapy and transurethral resection of the prostate (TURP) in patients who required benign prostatic obstruction (BPO) surgery and had storage symptoms.

Methods: The results of patients who had undergone TURP and RF thermotherapy procedures between December 2019 and 2022 were compared before and after the procedure. Patients' International Prostate Symptom Scores, maximum flow rate (Qmax), postvoiding residues, and overactive bladder validated 8 scores (OAB-V8) at 3 and 6 months were analyzed.

Results: While the preprocedural OAB-V8 in the RF thermotherapy group was 25.85, this score decreased to 18.12 (P<0.001) at the postprocedural 3rd month and 16.42 (P<0.001) at the postprocedural 6th month. While the preprocedural OAB-V8 score in TURP group was 23.26, it decreased to 20.17 (P<0.001) at the postprocedural 3rd month and 19.84 at the postprocedural 6th month, and there was no significant difference between the 3rd-month and 6th-month values (P=0.328). The proportion of de crease in the OAB-V8 scores was 30% at the 3rd month and 36% at the 6th month in the RF thermotherapy group, whereas it was 13% at the 3rd month and 15% at the 6th month in TURP group.

Conclusion: It was determined that RF thermotherapy was 2.35 times more effective than TURP on OAB-V8 scores. In addition to its acceptable effect on Qmax, its continued effect on storage symptoms at 6 months may be a significant advantage over the TURP. As a minimally invasive method, RF thermotherapy can be offered as a suitable option for BPO patients with storage symptoms.

Keywords: Benign prostatic obstruction; Radiofrequency; Storage symptoms; Thermotherapy; Transurethral resection.

Fig. 1

The figure shows the application procedure of radiofrequency thermotherapy.

Fig. 2

Preprocedural, postprocedural 3rd-month, and postprocedural 6th-month OAB-V8 scores of the groups. OAB-V8, overactive bladder validated 8 score; RF, radiofrequency; TURP, transurethral resection of the prostate.

Fig. 3

(A) Normal urothelium, submucosal tissue, and prostate parenchyma. (B) Secondary to benign prostatic obstruction; represents mucosal hypertrophy, increase of A delta and especially C nerve fibers and submucosal tissue. (C) Coagulation necrosis after radiofrequency thermotherapy.