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Transurethral microwave therapy in 200 patients with a minimum followup of 2 years: urodynamic and clinical results.
J Urol. 2002 Jun; 167(6):2496-501.JU

Abstract

PURPOSE

We investigated the long-term efficacy of the second generation Targis thermotherapy device (Urologix, Inc., Minneapolis, Minnesota) for decreasing outflow obstruction caused by benign prostatic hyperplasia.

MATERIALS AND METHODS

At a minimum followup of 24 months 200 patients with bladder outlet obstruction documented on urodynamics and cystoscopy document with preserved detrusor function underwent transurethral microwave therapy while under local anesthesia. In 45% of cases the general American Society of Anesthesiologists health score was 3 or greater.

RESULTS

After a median observation time of 42 months (range 2 to 72) 43 patients (22%) who required additional treatment (repeat thermotherapy, transurethral prostate resection or permanent cystostomy) were excluded from further analysis, as were 15 (7.5%) who died of causes unrelated to treatment during followup and 13 (6.5%) who were lost to followup or refused followup investigations. In the 162 patients evaluated 6 months after treatment the median International Prostate Symptom Score decreased from 23 points (range 10 to 34) before treatment to 3 (range 0 to 21) and remained stable at 12 and 24 months. Median maximum flow increased from 6 ml. per second (range 1 to 15) before treatment to 14.5 (range 4 to 50) 6 months after treatment and remained stable at 12 and 24 months. Median post-void residual urine volume decreased from 170 ml. (range 35 to 720) before treatment to 17 (range 0 to 327) after 6 months and then remained unchanged. Urodynamic evaluation in the 162 patients after 6 months showed a decrease from pretreatment median detrusor opening pressure of 87.5 to 53 cm. water. Median detrusor pressure at maximum flow decreased from 86 to 58 cm. water 6 (p <0.0001). At the 24-month followup 59 of the 129 evaluable patients agreed to undergo repeat urodynamic evaluation. Pressure flow analysis in these 59 cases revealed a decrease in median minimal urethral opening pressure from 70 to 40 cm. water at 6 months and to 38 cm. water at 24 months (p <0.0001). Median detrusor pressure at maximum flow decreased significantly from the pretreatment value of 86 to 55 cm. water at 6 months and 58 cm. water at 24 months (p <0.0001).

CONCLUSIONS

In patients with a good initial response to treatment, which is achieved in approximately 80%, transurethral microwave therapy provides excellent long-term subjective and objective results. Improved urinary flow, decreased post-void residual urine volume and urodynamic parameters remain stable at 2 years. Transurethral microwave therapy with second generation microwave equipment did not compromise any conventional treatment needed in the 22% of patients who were nonresponders at 6 months.

Authors+Show Affiliations

Department of Urology, University of Berne, Berne, Switzerland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11992066

Citation

Thalmann, George N., et al. "Transurethral Microwave Therapy in 200 Patients With a Minimum Followup of 2 Years: Urodynamic and Clinical Results." The Journal of Urology, vol. 167, no. 6, 2002, pp. 2496-501.
Thalmann GN, Mattei A, Treuthardt C, et al. Transurethral microwave therapy in 200 patients with a minimum followup of 2 years: urodynamic and clinical results. J Urol. 2002;167(6):2496-501.
Thalmann, G. N., Mattei, A., Treuthardt, C., Burkhard, F. C., & Studer, U. E. (2002). Transurethral microwave therapy in 200 patients with a minimum followup of 2 years: urodynamic and clinical results. The Journal of Urology, 167(6), 2496-501.
Thalmann GN, et al. Transurethral Microwave Therapy in 200 Patients With a Minimum Followup of 2 Years: Urodynamic and Clinical Results. J Urol. 2002;167(6):2496-501. PubMed PMID: 11992066.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Transurethral microwave therapy in 200 patients with a minimum followup of 2 years: urodynamic and clinical results. AU - Thalmann,George N, AU - Mattei,Agostino, AU - Treuthardt,Cédric, AU - Burkhard,Fiona C, AU - Studer,Urs E, PY - 2002/5/7/pubmed PY - 2002/6/18/medline PY - 2002/5/7/entrez SP - 2496 EP - 501 JF - The Journal of urology JO - J Urol VL - 167 IS - 6 N2 - PURPOSE: We investigated the long-term efficacy of the second generation Targis thermotherapy device (Urologix, Inc., Minneapolis, Minnesota) for decreasing outflow obstruction caused by benign prostatic hyperplasia. MATERIALS AND METHODS: At a minimum followup of 24 months 200 patients with bladder outlet obstruction documented on urodynamics and cystoscopy document with preserved detrusor function underwent transurethral microwave therapy while under local anesthesia. In 45% of cases the general American Society of Anesthesiologists health score was 3 or greater. RESULTS: After a median observation time of 42 months (range 2 to 72) 43 patients (22%) who required additional treatment (repeat thermotherapy, transurethral prostate resection or permanent cystostomy) were excluded from further analysis, as were 15 (7.5%) who died of causes unrelated to treatment during followup and 13 (6.5%) who were lost to followup or refused followup investigations. In the 162 patients evaluated 6 months after treatment the median International Prostate Symptom Score decreased from 23 points (range 10 to 34) before treatment to 3 (range 0 to 21) and remained stable at 12 and 24 months. Median maximum flow increased from 6 ml. per second (range 1 to 15) before treatment to 14.5 (range 4 to 50) 6 months after treatment and remained stable at 12 and 24 months. Median post-void residual urine volume decreased from 170 ml. (range 35 to 720) before treatment to 17 (range 0 to 327) after 6 months and then remained unchanged. Urodynamic evaluation in the 162 patients after 6 months showed a decrease from pretreatment median detrusor opening pressure of 87.5 to 53 cm. water. Median detrusor pressure at maximum flow decreased from 86 to 58 cm. water 6 (p <0.0001). At the 24-month followup 59 of the 129 evaluable patients agreed to undergo repeat urodynamic evaluation. Pressure flow analysis in these 59 cases revealed a decrease in median minimal urethral opening pressure from 70 to 40 cm. water at 6 months and to 38 cm. water at 24 months (p <0.0001). Median detrusor pressure at maximum flow decreased significantly from the pretreatment value of 86 to 55 cm. water at 6 months and 58 cm. water at 24 months (p <0.0001). CONCLUSIONS: In patients with a good initial response to treatment, which is achieved in approximately 80%, transurethral microwave therapy provides excellent long-term subjective and objective results. Improved urinary flow, decreased post-void residual urine volume and urodynamic parameters remain stable at 2 years. Transurethral microwave therapy with second generation microwave equipment did not compromise any conventional treatment needed in the 22% of patients who were nonresponders at 6 months. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/11992066/Transurethral_microwave_therapy_in_200_patients_with_a_minimum_followup_of_2_years:_urodynamic_and_clinical_results_ DB - PRIME DP - Unbound Medicine ER -