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TURP and low‐energy TUMT treatment in men with LUTS suggestive of bladder outlet obstruction selected by means of pressure‐flow studies: 8‐year follow‐up
Author(s) -
Vesely Stepan,
Knutson Tomas,
Damber JanErik,
Dicuio Mauro,
Dahlstrand Christer
Publication year - 2006
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.20233
Subject(s) - medicine , bladder outlet obstruction , urology , prostate , transurethral resection of the prostate , hyperplasia , benign prostatic hyperplasia (bph) , surgery , cancer
Aims To evaluate the long‐term outcome of transurethral resection of the prostate (TURP) and transurethral microwave thermotherapy (TUMT) in men with symptomatic benign prostatic hyperplasia (BPH), when allocation to the treatment‐group was based on urodynamic diagnosis of bladder outlet obstruction (BOO). Methods A total of 231 elderly men with symptomatic BPH were treated either by TURP or by low‐energy TUMT. A pressure‐flow study was performed to detect the obstruction and to help in the selection of the two treatments. The patients were examined at baseline then checked again after 2 and 8 years. Results At 2 years of follow‐up there was a significant improvement for both IPSS and QoL ( P < 0.0001) in both groups of treatment. This was accompanied by a significant improvement ( P < 0.0001) in the maximum flow rate from 10.0 (5.8) to 16.4 (7.6) in the TURP group and from 12.1 (5.2) to 14.9 (5.7) in the TUMT group. These findings persisted at 8 years, they were, however, more pronounced after TURP. The overall retreatment rate reached a value of 11% in the TURP group and 27% in the TUMT group, respectively. At the follow‐up, 95% of the patients who underwent TURP and 70% of the patients treated by TUMT claimed to be satisfied with that choice. Conclusions With durable symptomatic improvement and lowest retreatment rate, TURP still presents a standard treatment option for patients with severe BOO. Low‐energy TUMT has sufficiently relieved patients' symptoms and can be offered to less obstructed patients as an alternative. Neurourol. Urodynam. 25:770–775, 2006. © 2006 Wiley‐Liss, Inc.