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Radiofrequency ablation of prostate using bipolar technology
Author(s) -
WOO H.
Publication year - 2006
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2006.06085_93.x
Subject(s) - ablation , prostate , medicine , cancer
Monopolar radiofrequency ablation has become an accepted modality within minimally invasive treatments for benign prostatic obstruction (BPO). Lesions created by bipolar technology are greater in size than those produced by monopolar devices. Recently, a bipolar system has been developed. This pilot study aims to determine if there is sufficient efficacy of this bipolar system to justify further clinical studies. Patients and Methods: Fourteen patients with BPO were identified for this pilot study of radiofrequency interstitial thermotherapy (RFITT) using the CelonUro TM bipolar probe and generator (OLYMPUS Winter and Ibe GmbH). Inclusion criteria included IPSS>12, QL>2 and Qmax<12 ml/s. The mean age was 62 years (range 53–77) and the mean TRUS prostate size was 33.7 cc(range 15–66). The majority treated on a day case basis. Results: The mean number of radiofrequency lesions per prostate was 6.2 (range 3–12). The mean operating time was 19.8 min (12–34). Baseline IPSS, QL, Qmax and PVR were respectively 23, 4.8, 7.1 ml/s and 168 ml. Ten patients have 6–12 data and nine patients have 12‐month follow up data. At 6–12 weeks and at one year followup, there are highly statistically significant ( P < 0.01) and clinical significant improvements in IPPS, QL, Qmax and PVR. These were respectively, 12.8, 2.1, 14 ml/s, 75 ml and 10.3, 1.7, 12.5 ml/s and 77 ml. Two patients developed urinary retention; both were catheter free by 4 weeks but one was salvaged with TURP by request of the patient. No retrograde ejaculation was reported amongst those who were sexually active. No other complications were reported. Conclusions: RFITT represents a further development in radiofrequency technology for the minimally invasive treatment of BPO. These early results indicate potential efficacy of bipolar radiofrequency ablation to treat BPO. Randomised studies using bipolar RFITT are necessary to determine its positioning between drug therapy and cavitating surgical procedures in terms of efficacy and morbidity profile.