Durability of 30-Minute High-Energy Transurethral Microwave Therapy for Treatment of Benign Prostatic Hyperplasia: A Study of 213 Patients With and Without Urinary Retention

Abstract

To evaluate the durability of transurethral microwave therapy (TUMT) Prostasoft 3.5 for the treatment of patients with benign prostatic hyperplasia treated with the 30-minute protocol. A total of 213 patients (45 with urinary retention) were treated with TUMT Prostasoft 3.5. The International Prostate Symptom Score (IPSS), quality of life (QOL) score, and maximal flow rate (Qmax) were assessed at baseline and at 12, 24, 36, 48, and 60 months of follow-up. The overall mean follow-up period was 33.9 months, with a maximum of 65 months. Patients without retention had significant improvement (P <0.0001) in the Qmax for up to 4 years (from 8.5 to 13.2 mL/s). The mean IPSS had decreased significantly from 20.3 to 12.2 at 5 years (P <0.0001). Similarly, the mean QOL score improved significantly during follow-up (P <0.0001). In the retention group, analysis showed that the clinical outcomes in terms of Qmax, IPSS, and QOL score remained stable during the follow-up period. Retreatment was required for 48 patients without urinary retention (28.6%) and 17 patients with retention (37.8%). The corresponding Kaplan-Meier cumulative retreatment risk at 5 years was estimated to be 42.3% and 58.8%. Our long-term data have indicated that the IPSS and QOL score remained improved in responders compared with their pretreatment scores 5 years after the 30-minute TUMT protocol and the Qmax remained significantly increased for up to 4 years. However, a significant number of patients required additional treatment, with those in retention before TUMT at a greater risk.