Transurethral resection of the prostate vs high-energy thermotherapy of the prostate in patients with benign prostatic hyperplasia: long-term results

Abstract

Objective: To evaluate the outcome and durability of high-energy transurethral microwave thermotherapy (HE-TUMT) in comparison with transurethral resection of the prostate (TURP).

Patients and methods: Fifty-two patients with BPH and lower urinary tract symptoms were randomized and treated either by TURP (21 patients; mean prostate volume 45 mL, SD 15) or HE-TUMT (31 patients, mean prostate volume 43 mL, SD 12). Long-term results were obtained at a mean (SD) follow-up of 2.4 (0.5) years.

Results: During the follow-up, the mean symptomatic improvement stabilized at 56% after TUMT and 74% after TURP. The mean maximum urinary flow rate increased by 62% after TUMT and 105% after TURP. Before treatment, 78% of patients in the TURP group were obstructed according to urodynamic investigation and after treatment, 14% remained obstructed. In the TUMT group, 67% of patients were obstructed before treatment and 33% remained so afterward. Six patients (19%) underwent TURP after TUMT (four after 1 year) and two patients were also treated with medication. One patient underwent a bladder neck incision after TURP to treat bladder neck sclerosis. Three patients were not satisfied with the outcome after the additional TURP.

Conclusion: Both treatment modalities show good symptomatic and objective results at > 2 years of follow-up. Most re-treatments were performed > or = 1 year after treatment and were based on subjective findings.