Endotext.com - BENIGN PROSTATE DISORDERS: "Other Minimally Invasive Therapies
Thermoablation is the principle underlying the remaining minimally invasive available treatments that have been introduced thus far174 and these include transurethral microwave thermotherapy and transurethral electrovaporization of the prostate.
In a study of 200 patients undergoing transurethral microwave thermotherapy (TUMT), a good initial response was achieved in 80% of patients175. However, 22% of patients in this study required re-treatment with conventional methods and there was a significant complication rate reported. As such it is a second line option only at this stage176. In a further study of high energy TUMT versus TURP, the IPSS improved in the TUMT group by 60% in year 1 however by 3 years, the improvement was not as apparent, being only 43% on IPSS.. Again, the re-treatment rate was 20% at 3 years. Voiding flow rate as measured by uroflowmetry improved by 64% at year 1, but this reduced to 29% by the end of year 3. This may be compared to the �gold-standard� TURP which had an IPSS reduction of 80-85% that remained stable over the 3 years, with a re-treatment rate of only 13%. Voiding flow rates improved by 214% in the TURP group and remained stable whilst re-treatments were generally for complications (eg. strictures or bladder neck contractures) rather than treatment failures177. Note that with lower energy TUMT protocols there is much less improvement in IPSS scores and voiding flow rates, and with 50-60% pre-treatment rates178.
Transurethral electrovaporization of the prostate (TUVT) has had promising results. In a study of 235 men randomised to TURP or TUVT, both groups achieved IPSS reductions of around 12 points and improvements in Qmax of 10ml/sec179. However, TUVT did not lead to a reduction in postoperative morbidity or shorter hospital stays."
