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Transurethral Microwave Thermotherapy for Symptomatic benign Prostatic Hyperplasia: Long–Term Durability with Prostcare

Objective: To evaluate the long–term durability of transurethral microwave thermotherapy (TUMT) with Prostcare for symptomatic benign prostatic hyperplasia (BPH). Patients and Methods: From August 1993 to July 1994, a total of 65 patients with symptomatic BPH who underwent TUMT using the Prostcare apparatus (Bruker Spectospin, Wissembourg, France) with low–energy protocol (maximal power 52 W) were enrolled into a short–term evaluation. Subsequent follow–up information was collected in July 1999. If patients had had any further therapy for BPH, the date of retreatment was considered as an endpoint of TUMT efficacy. If no further therapy for BPH had been needed, they were re–assessed for overall satisfaction. Results: The median follow–up period was 49 months. Twenty patients were excluded for various reasons, including 17 with loss of follow–up and 3 with new diseases that could affect the voiding status. Thirty–eight (84.4%) of 45 valuable patients had received further therapy for BPH, including medication (n = 21, 46.7%), and endoscopic surgery (n = 17, 37.7%). The times to pharmacologic or endoscopic retreatment after TUMT were 8.9±11.1 and 23.0±14.4 months, respectively (p = 0.0003, log rank test). Only 7 (15.5%) patients had no further treatment, with 3 having satisfactory improvements, but 4 feel dissatisfied yet not needing any further therapy. In addition, 2 patients complained of erectile dysfunction after TUMT and 1 was diagnosed with prostate cancer 50 months after TUMT. In addition, there was no significant difference for all baseline values among three groups with no retreatment or retreatment with medication or endoscopic surgery. Conclusion: At the 5–year follow–up, the long–term durability of low–energy TUMT with Prostcare is only exhibited in a few patients and the overall retreatment rate was 84.4%. Thus, patient should be informed of the high probability of supplementary treatment after TUMT.