Is There a Role for Transrectal Microwave Hyperthermia in the Treatment of Benign Prostatic Hyperplasia? A Critical Review of a Six-Year Experience

Abstract

We critically reviewed our 6-year experience with transrectal microwave hyperthermia of the prostate for benign prostatic hyperplasia (BPH) in 320 patients either at high surgical risk or refusing surgery. Transrectal prostatic hyperthermia was given in five to ten 60-minute sessions with an intraprostatic temperature ranging from 42 degrees to 43.5 degrees C. Although an amelioration of symptoms and urodynamic measures was seen initially in most patients, only residual urine volume showed a statistically and clinically significant improvement at the long-term follow-up. According to maximum flow nomograms, bladder outlet obstruction was not resolved by the treatment. We conclude that although the transrectal hyperthermia proved to be a safe procedure, it did not cure BPH in the long term. Considering the results seen with newer nonsurgical procedures such as prostatic stents and prostatic lasers, we believe that transrectal hyperthermia should not be recommended to symptomatic BPH patients.

Thermal ablation of prostate diseases: advantages and limitations

“…In early studies, a transrectal microwave device was applied to increase prostate tissue temperature of 42-43 C. However, this hyperthermia resulted in no durable efficacy and was abandoned 26 . The current concept of thermal therapy for BPH is to destroy the hypertrophic tissue in the peri-urethral area (transition zone) by tissue temperature increased to more than 45 C. For this purpose, a transurethral approach has been commonly chosen due to the pathology located around the urethra.…”

The Effects of Microwave Thermotherapy for Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Prospective, Randomized Study

“…Transrectal microwave hyperthermia of the prostate was developed as a treatment for prostate cancer [6][7][8], and its application was subsequently extended to benign prostatic hyperplasia and CP [9,10]. Transrectal prostatic hyperthermia has shown efficacy in selected patients with CP who did not respond to conventional therapies [11,12]. This study evaluated the effect of transrectal microwave thermotherapy (TRMT).…”