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  • Title: Transurethral microwave treatment for benign prostatic hypertrophy: a randomised controlled clinical trial.
    Author: Bdesha AS, Bunce CJ, Kelleher JP, Snell ME, Vukusic J, Witherow RO.
    Journal: BMJ; 1993 May 15; 306(6888):1293-6. PubMed ID: 7686065.
    Abstract:
    OBJECTIVES: To determine whether transurethral microwave treatment for patients with benign prostatic hypertrophy provides significant symptomatic relief, a reduction in residual urine volumes, and improvements in flow rates compared with sham treatment. DESIGN: Prospective double blind randomised study with follow up at three months. SETTING: Department of Urology in a London teaching hospital. PATIENTS: 40 men completed the study: 22 received microwave treatment and 18 received sham treatment. Entry criteria were symptoms of prostatism of at least six months' duration, a total symptom score > 14, and a peak urine flow rate < 15 ml/s or a residual urine volume > 50 ml. Exclusion criteria were prostatic cancer, a residual urine volume > 200 ml, a very large prostate, an obstructing middle lobe, acute urinary retention, impaired renal function, coexisting urinary tract disease, and previous prostatic surgery. INTERVENTIONS: A single 90 minute transurethral microwave treatment or sham treatment. OUTCOME MEASURES: Patients' symptoms (including daytime frequency and nocturia) recorded in a self assessment symptom score questionnaire, peak urinary flow rates, and residual urine volumes. RESULTS: The mean total symptom scores of the patients who received microwave treatment fell from 30 to 11 compared with a fall from 31 to 26 for patients who received sham treatment (p < 0.001). Among patients who received microwave treatment daytime frequency fell from 9.4 to 5.5 voids a day and night time frequency from 3.5 to 1.6 voids a night; residual urine volumes fell from 104 ml to 52 ml; and peak urine flow rates increased by 2.3 ml/s. In the control group there was no improvement in any of these features. Treatment preserved sexual function and antegrade ejaculation. CONCLUSIONS: For selected patients with prostatism microwave treatment is effective and has few side effects.
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