Efficacy of bipolar RF thermotherapy in BPH treatment
Introduction: Although TURP is stil remain "gold standard" in surgical treatment of BPH, urologists and patients are looking for less invasive, outpatient procedures for reducing prostate's size and lower urinary tract symptoms. Some such procedures were developed as TUNA, microwave therapy, botulinic toxin's or alcohol injections. In our clinic we've decided to use bipolar-radiofrequency thermotherapy and evaluate efficacy of this method.
Material & Methods: 35 patients were included to this study with age 53 - 76 years. Average prostate volume was: 52,15 cm3 (33,80 - 81,40), Qmax: 9,19 ml/sec (4,40 - 13,10 ml/s), PVR: 51,43 ml (0 - 100 ml).
All patients filled IPSS questionnaire, but we didn't include it in study's protocol, because IPSS mainly reflects subjective feeling of patients.
Exclusion criteria's were: prostate cancer, prostate's volume more 90 cm3, PVR more 100 ml. All patients undergone bipolar-RF thermotherapy (“Tempro”(DIREX - INITIA) with temperature 48 - 53 C
during 1 hour.
Unfortunately, we didn't create "sham group", because it's difficult to simulate sensation of thermotherapy. Follow-up period was 6 months.
Prostate volume(sm3): before - 52,15; 6 months after - 41,53*
Qmax (ml/s): before - 9,19; after - 14,31*
PVR (ml): before - 51,43; after - 20,57*
Main complication was AUR that indicated permanent catheterisation within 24 - 72 hours.
Conclusions: Certainly, bipolar-RF thermotherapy couldn't compete with TURP, but it could be solution for patients who have contraindications for surgery or afraid it. Now we are performing multicenter trial with thermotherapy of BPH and going to present results in 2015.
Y.Mirkin, A.Karapetyan, S.Shumoff (URO-PRO Clinics)