Elevation of sensory thresholds in the prostatic urethra after microwave thermotherapy

Abstract

Objectives To determine whether transurethral microwave thermotherapy (TUMT) affects the sensory threshold in the posterior urethra and whether such an effect in¯uences urinary storage symptoms. Patients and methods The sensory threshold was measured before and at 3 and 12 weeks after TUMT in 13 men with minor obstructive symptoms caused by benign prostatic hyperplasia. Sensations were evoked by electrical stimulation at different frequencies, using a bipolar ring-electrode mounted on a urethral catheter. Changes in sensory thresholds were evaluated in the patients both as a group and individually. The patients were interviewed about their symptoms at each measurement.Results After TUMT, 12 patients were satis®ed and reported decreased irritative symptoms, primarily less frequent nocturnal micturition; two patients were cured of urgency incontinence. In 11 of the satis®ed patients, and the unsuccessful patient, decreased urge accompanied increased sensory thresholds. Thresholds elevated by o 30% were correlated with decreased irritative symptoms. Conclusions TUMT decreases sensitivity in the posterior urethra, which may alleviate storage symptoms.

TUMT 2.0: Results Three Months and Three Years after Treatment

“…We could not confirm any of the above statements, nor did the results seem to be influenced by prostatic volume or dose of microwave energy. It has been demonstrated that sensitivity in the posterior urethra is decreased following microwave treatment, and that this was correlated to a decrease of reservoir symptoms (10). Denervation of periurethral prostatic tissue has also been found when resection is done one week after microwave treatment (11).…”

High‐energy transurethral microwave thermotherapy: symptomatic vs urodynamic success

“…Patients were reported to be equally satisfied with low‐energy [11–13] and high‐energy protocols, either with the present device [14] or with other high‐energy devices [7,8,13]. This improvement is attributed to a decrease in the sensitivity of the posterior urethra secondary to damage of the sensory neurones and reduction of the excitatory signals from the urethro‐detrusor facilitating fibres, and that might alleviate the storage symptoms [15].…”

Management of benign prostatic hyperplasia with silodosin

“…1 There are various options for the treatment of BPH, including transurethral resection of the prostate, 5,6 minimally invasive therapies for BPH including microwave thermotherapy, 7 holmium:YAG laser prostatectomy, 8,9 or transurethral resection in saline (TURIS), 10,11 and pharmacotherapy. Among these options, medical therapy with an α 1 -AR antagonist is widely used as a conservative treatment for LUTS/BPH or neurogenic bladder dysfunction.…”