|
Transurethral microwave thermotherapy (TUMT) has been widely reported for the treatment of benign prostatic hyperplasia (BPH) but with variable results. This is likely due to the inability to develop and maintain high intraprostatic temperatures. The T3 device has a preferential heating pattern which prevents shutdowns as a result of rectal heating thus allowing continuous energy delivery throughout the therapy. High temperatures greater than 70 degrees Celsius are maintained resulting in extensive coagulative necrosis in the transitional zone. Treatment was performed in an outpatient clinic using topical anaesthesia with occasional low dose I.V. analgesia. One hundred and fifty-four patients have been treated in 3 centers using a similar protocol. Inclusion criteria required an AUA symptom score greater than or equal to 9 and a peak uroflow rate less than or equal to 12 ml/sec. Mean prostate size was 40.6 cc. One hundred and eighteen patients have been followed for at least 12 months, and 58 for 24 months. AUA symptom score decreased from a mean of 19.8 to 8.9 (12 M), and 7.6 (24 M). Improvement was seen in all 7 symptoms evaluated. Peak flow rates increased from a mean of 9.3 to 13.4 (12 M), and 13.1 (24 M). Improvement in symptom score and peak flow was observed across all prostate sizes. By 2 years, 15 patients had dropped out of the study, 8 for alternative treatment (6 TURP, 1 bladder neck incision, 1 urethrotomy) and 7 for administrative or other reasons. Treatment with the T3 device provides excellent improvement in symptoms, flow rates and patients satisfaction. T3 fulfills the criteria for an effective, minimally invasive, outpatient treatment for symptomatic BPH.
|
