TRANSURETHRAL MICROWAVE THERMOTHERAPY FOR BENIGN PROSTATE HYPERPLASIA: SEPARATING TRUTH FROM MARKETING HYPE
2004; Lippincott Williams & Wilkins; Volume: 172; Issue: 4 Part 1 Linguagem: Inglês
10.1097/01.ju.0000129967.30558.ca
ISSN1527-3792
AutoresK. Walmsley, Steven A. Kaplan,
Tópico(s)Optical properties and cooling technologies in crystalline materials
ResumoNo AccessJournal of UrologyReview Articles1 Oct 2004TRANSURETHRAL MICROWAVE THERMOTHERAPY FOR BENIGN PROSTATE HYPERPLASIA: SEPARATING TRUTH FROM MARKETING HYPEis corrected byRE: TRANSURETHRAL MICROWAVE THERMOTHERAPY FOR BENIGN PROSTATE HYPERPLASIA: SEPARATING TRUTH FROM MARKETING HYPE KONSTANTIN WALMSLEY and STEVEN A. KAPLAN KONSTANTIN WALMSLEYKONSTANTIN WALMSLEY and STEVEN A. KAPLANSTEVEN A. KAPLAN View All Author Informationhttps://doi.org/10.1097/01.ju.0000129967.30558.caAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Transurethral microwave thermotherapy (TUMT) is being used with increasing frequency by urologists as a minimally invasive therapy for benign prostatic hyperplasia (BPH). There are various modifications to this technology, with each manufacturer touting safety and efficacy. We review the rationale of TUMT, as well as the historical safety and efficacy of this approach. Materials and Methods: We reviewed the medical literature, including peer reviewed articles and abstracts. In addition, we analyzed promotional material distributed by various manufacturers with respect to scientific accuracy. Results: TUMT results in consistent improvement in symptoms and peak urinary flow rate. Symptom improvement ranges between 9 and 11 points, compared to a 6-point improvement in sham treated patients, and peak urinary flow rate increases 3 to 5 ml per second. The degree of coagulation necrosis is different among the various TUMT devices. Although coagulation necrosis is believed to be an important proxy for clinical success, there are few data that correlate this factor with the magnitude of either symptomatic or uroflow improvement. Conclusions: TUMT is a safe and effective therapy for the treatment of lower urinary tract symptoms secondary to BPH. In addition, there are distinct advantages to each of the devices. However, intense marketing and hyperbole have dominated this segment of the BPH market. Ultimately, the most effective TUMT device can only be determined by direct comparison studies. References 1 : Transrectal and transurethral hyperthermia versus sham treatment in benign prostatic hyperplasia: a double-blind randomized multicentre clinical trial. The French BPH Hyperthermia. Br J Urol1995; 76: 619. Google Scholar 2 : First Canadian clinical study of transurethral hyperthermia in benign prostatic hyperplasia. Assessment of 220 patients. Eur Urol1992; 21: 184. Google Scholar 3 : Interstitial temperature measurements during transurethral microwave hyperthermia. J Urol1991; 145: 304. Link, Google Scholar 4 : Intraprostatic temperature monitoring during transurethral microwave thermotherapy for the treatment of benign prostatic hyperplasia. J Urol1998; 159: 1583. Link, Google Scholar 5 : (TURF) transurethral radiofrequency heating for benign prostatic hyperplasia at various temperatures with Thermex II: clinical experience. Eur Urol1993; 23: 302. Google Scholar 6 : Transurethral hot-water balloon thermoablation for benign prostatic hyperplasia: patient tolerance and pathologic findings. Urology2000; 56: 76. Google Scholar 7 : Effect of heat exposure on viability and contractility of cultured prostatic stromal cells. Eur Urol2000; 37: 499. Google Scholar 8 : Current status of thermotherapy of the prostate. J Urol1997; 157: 430. Link, Google Scholar 9 : Clinical response to transurethral microwave thermotherapy is thermal dose dependent. Eur Urol1993; 23: 267. Google Scholar 10 : Supraphysiological thermal injury in Dunning AT-1 prostate tumor cells. J Biomech Eng2000; 122: 51. Google Scholar 11 : Evaluation of thermal therapy in a prostate cancer model using wet electrode radiofrequency probe. J Endourol2001; 15: 629. Google Scholar 12 : Heat sensitivity of human prostatic tissue: implications for thermal therapy. J Urol2003; 169: 287. abstract 1115. Google Scholar 13 : Cell-kill modelling of microwave thermotherapy for benign prostatic hyperplasia. J Endourol2000; 14: 627. Google Scholar 14 : Results of a new advancement in high temperature cooled thermotherapy (TUMT) for benign prostatic hyperplasia (BPH). J Urol2003; 169: 390. abstract 1459. Google Scholar 15 : Intraprostatic temperature measurement during microwave treatment provides online control of tissue necrosis volume using ProstaLund microwave feedback. J Endourol2001; 15: A89. Google Scholar 16 : Correlations between prostate volume reduction and clinical variables after microwave thermotherapy. J Urol2003; 169: 347. abstract DP32. Google Scholar 17 : Microwave thermotherapy in patients with benign prostatic hyperplasia and chronic urinary retention. Eur Urol2001; 39: 400. Google Scholar 18 : Cooled thermotherapy for the treatment of benign prostatic hyperplasia: durability of results obtained with the Targis System. Urology2003; 61: 160. Google Scholar 19 : Long term efficacy and durability in 345 patients treated with transurethral microwave thermotherapy for benign prostatic hyperplasia: five year results. J Urol2002; 167: 297. abstract 1153. Google Scholar 20 : Transurethral microwave thermotherapy (TUMT) with the Targis System: a single-centre study on 78 patients with acute urinary retention and poor general health. Eur Urol2003; 43: 176. Google Scholar 21 : Transurethral microwave therapy in 200 patients with a minimum followup of 2 years: urodynamic and clinical results. J Urol2002; 167: 2496. Link, Google Scholar 22 : Office-based transurethral microwave thermotherapy using the Thermatrx TMx-2000. J Endourol2002; 16: 57. Google Scholar 23 : Transurethral microwave thermotherapy (TUMT) using the Thermatrx TMX-2000: durability exhibited in a study comparing TUMT with a sham procedure in patients with benign prostatic hyperplasia (BPH). J Urol2003; 169: 465. abstract 1746. Google Scholar 24 : Sexual function following high energy microwave thermotherapy: results of a randomized controlled study comparing transurethral microwave thermotherapy to transurethral prostatic resection. J Urol1999; 161: 486. Link, Google Scholar 25 : Transurethral resection of the prostate versus high-energy thermotherapy of the prostate in patients with benign prostate hyperplasia: long term results. Br J Urol1998; 81: 259. Google Scholar 26 : Impact of interventional therapy for benign prostatic hyperplasia on quality of life and sexual function: a prospective study. J Urol2000; 164: 1206. Link, Google Scholar 27 : Long-term followup of randomized transurethral microwave thermotherapy versus transurethral prostatic resection study. J Urol2001; 165: 1533. Link, Google Scholar 28 : Feedback microwave thermotherapy versus TURP for clinical BPH—a randomized, controlled multicenter study. Urology2002; 60: 292. Google Scholar 29 : Baseline prostate specific antigen does not predict the outcome of high energy transurethral microwave thermotherapy. J Urol2002; 167: 1727. Link, Google Scholar 30 : Efficacy and safety of intraprostatic temperature-controlled microwave thermotherapy in patients with benign prostatic hyperplasia: results of a prospective, open-label, single-center study with a 1-year follow-up. J Endourol2003; 17: 425. Google Scholar 31 : Targeted transurethral microwave thermotherapy versus alpha-blockade in benign prostatic hyperplasia: outcomes at 18 months. Urology2001; 57: 66. Google Scholar 32 : Long term results (4 years) of high-energy transurethral microwave. Eur Urol2003; 2: 102. Google Scholar 33 : Efficacy and durability of the 30 minutes high energy TUMT protocol in 213 patients. J Endourol2002; 15: 38. abstract P023. Google Scholar 34 : AUA guideline on management of benign prostatic hyperplasia (2003). Chapter 1: diagnosis and treatment recommendations. J Urol2003; 170: 530. Link, Google Scholar 35 : How do transurethral needle ablation of the prostate and transurethral microwave thermotherapy compare with transurethral prostatectomy?. Curr Urol Rep2003; 4: 297. Google Scholar From the Department of Urology, College of Physicians and Surgeons, Columbia University, New York, New York© 2004 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byYu X, Elliott S, Wilt T and McBean A (2018) Practice Patterns in Benign Prostatic Hyperplasia Surgical Therapy: The Dramatic Increase in Minimally Invasive TechnologiesJournal of Urology, VOL. 180, NO. 1, (241-245), Online publication date: 1-Jul-2008.Kaplan S (2018) High-Energy Transurethral Microwave Thermotherapy in Patients With Benign Prostatic Hyperplasia: Comparative Study Between 30- and 60-Minute Single TreatmentsJournal of Urology, VOL. 174, NO. 4 Part 1, (1352-1353), Online publication date: 1-Oct-2005.Related articlesJournal of Urology9 Nov 2018RE: TRANSURETHRAL MICROWAVE THERMOTHERAPY FOR BENIGN PROSTATE HYPERPLASIA: SEPARATING TRUTH FROM MARKETING HYPE Volume 172Issue 4 Part 1October 2004Page: 1249-1255 Advertisement Copyright & Permissions© 2004 by American Urological Association, Inc.Keywordsprostateprostatic hyperplasiatransurethral resection of prostatemicrowavesMetricsAuthor Information KONSTANTIN WALMSLEY More articles by this author STEVEN A. 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