Durability of results obtained with transurethral microwave thermotherapy in the treatment of men with symptomatic benign prostatic hyperplasia.

To assess the durability of the results of transurethral microwave thermotherapy (TUMT) for symptomatic benign prostatic hyperplasia (BPH), we have reviewed publications describing trials with at least 3 years of follow-up. For men treated only by TUMT, improvement in symptoms and quality of life appears to be maintained for at least 4 to 5 years. Improvement in peak flow rates is modest but is generally maintained, particularly after higher-energy therapies. These results represent responders, and a crucial question is the need for additional treatments. With lower-energy treatment, this is common: between 50% and 60% within 3 to 5 years. With higher-energy TUMT, the retreatment rate appears to be less, approximating 20% within 3 to 4 years. When comparing these results with those of transurethral resection, it should be noted that there is a significant failure rate with surgery, and even if failure is more common with TUMT, men may be prepared to accept this risk rather than the greater morbidity of prostatectomy.