Single-Session Transurethral Microwave Thermotherapy for the Treatment of Benign Prostatic Obstruction*

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Abstract
The Prostatron device, which provides simultaneous microwave heating of the prostate and conductive cooling of the urethra, was used in 50 men with significant urethral obstruction by benign prostatic hyperplasia (BPH). The prostate was heated to 45.5°C for 55 minutes in most cases. No anesthesia or sedation was required. Of the 19 patients in acute retention before treatment, one died of disseminated renal cancer soon after treatment and three are awaiting a voiding trial. Eight men voided normally after catheter withdrawal, six of whom continue to void normally. One went into retention again after a further surgical procedure, and one had the catheter replaced for social reasons. Two other patients had catheters replaced, and seven underwent transurethral resection. All 23 patients with outflow obstruction before treatment had improvement in their symptom scores at 6 and 12 weeks. In six patients with obstruction and an abnormal bladder, one of three had a reduction in postvoiding residual volume, one of two with a low flow rate was improved, and one patient with Parkinson's disease achieved marked symptom reduction and lessened obstruction. Treatment failed in two patients because of inability to insert the applicator or technical malfunction. The only side effects were self-limited urethral bleeding and short-term obstruction apparently secondary to urethral edema. The authors suggest some roles for transurethral thermotherapy in the management of BPH.

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