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Transurethral microwave thermotherapy for benign prostatic hyperplasia: Relation between clinical response and prostate histology
Author(s) -
Arai Yoichi,
Fukuzawa Shigeki,
Terai Akito,
Yoshida Osamu
Publication year - 1996
Publication title -
the prostate
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.295
H-Index - 123
eISSN - 1097-0045
pISSN - 0270-4137
DOI - 10.1002/(sici)1097-0045(199602)28:2<84::aid-pros2>3.0.co;2-n
Subject(s) - prostate , medicine , urology , hyperplasia , histology , biopsy , prostate biopsy , international prostate symptom score , prostatic urethra , stromal cell , lower urinary tract symptoms , cancer
The effectiveness of transurethral microwave thermotherapy (TUMT) for BPH has been confirmed. To identify the characteristics of the ideal candidate, retrospective analysis and morphometric study of prostatic tissue were performed. Forty‐two patients with symptomatic BPH were included in the study; these comprised 10 patients treated for more than 3 months with anti‐androgen pre‐TUMT (group A) and 32 fresh cases (group B). Subjective and objective responses were evaluated at 2 months post TUMT. In 12 fresh cases who underwent pre‐TUMT biopsy of the prostate, the stromal‐to‐epithelial ratio was determined via quantitative image analysis on a computer‐assisted morphometry system. No significant differences in baseline patient characteristics were found between the two groups: age, prostate volume, peak flow rate (PFR), or International Prostate Symptom Score (I‐PSS). However, significant differences in treatment outcome were found between the two groups (group A vs. group B, respectively): total energy delivered to the prostate: 96 kJ vs. 125 kJ; I‐PSS decrease from baseline: 5.9 vs. 11.6; PFR increase from baseline: 1.1 vs. 4.7 ml/sec. There was a positive correlation between the I‐PSS change from baseline and the stromal‐to‐epithelial ratio of the prostatic tissue (r = 0.4857). The results suggest that microwave interacts poorly with the prostate due to the artificially created “lack” of glandular tissue. The morphometric study also supports the contention that the histological composition of the prostatic tissue plays an important role in terms of microwave thermal interactions and treatment outcome. © 1996 Wiley‐Liss, Inc.