Konstantin Walmsley1, Steven A Kaplan. 1. Department of Urology, College of Physicians and Surgeons, Columbia University, New York, New York 10032, USA.
Abstract
PURPOSE: Transurethral microwave thermotherapy (TUMT) is being used with increasing frequency by urologists as a minimally invasive therapy for benign prostatic hyperplasia (BPH). There are various modifications to this technology, with each manufacturer touting safety and efficacy. We review the rationale of TUMT, as well as the historical safety and efficacy of this approach. MATERIALS AND METHODS: We reviewed the medical literature, including peer reviewed articles and abstracts. In addition, we analyzed promotional material distributed by various manufacturers with respect to scientific accuracy. RESULTS: TUMT results in consistent improvement in symptoms and peak urinary flow rate. Symptom improvement ranges between 9 and 11 points, compared to a 6-point improvement in sham treated patients, and peak urinary flow rate increases 3 to 5 ml per second. The degree of coagulation necrosis is different among the various TUMT devices. Although coagulation necrosis is believed to be an important proxy for clinical success, there are few data that correlate this factor with the magnitude of either symptomatic or uroflow improvement. CONCLUSIONS: TUMT is a safe and effective therapy for the treatment of lower urinary tract symptoms secondary to BPH. In addition, there are distinct advantages to each of the devices. However, intense marketing and hyperbole have dominated this segment of the BPH market. Ultimately, the most effective TUMT device can only be determined by direct comparison studies.
PURPOSE: Transurethral microwave thermotherapy (TUMT) is being used with increasing frequency by urologists as a minimally invasive therapy for benign prostatic hyperplasia (BPH). There are various modifications to this technology, with each manufacturer touting safety and efficacy. We review the rationale of TUMT, as well as the historical safety and efficacy of this approach. MATERIALS AND METHODS: We reviewed the medical literature, including peer reviewed articles and abstracts. In addition, we analyzed promotional material distributed by various manufacturers with respect to scientific accuracy. RESULTS: TUMT results in consistent improvement in symptoms and peak urinary flow rate. Symptom improvement ranges between 9 and 11 points, compared to a 6-point improvement in sham treated patients, and peak urinary flow rate increases 3 to 5 ml per second. The degree of coagulation necrosis is different among the various TUMT devices. Although coagulation necrosis is believed to be an important proxy for clinical success, there are few data that correlate this factor with the magnitude of either symptomatic or uroflow improvement. CONCLUSIONS: TUMT is a safe and effective therapy for the treatment of lower urinary tract symptoms secondary to BPH. In addition, there are distinct advantages to each of the devices. However, intense marketing and hyperbole have dominated this segment of the BPH market. Ultimately, the most effective TUMT device can only be determined by direct comparison studies.
Authors: Juan Victor Ariel Franco; Luis Garegnani; Camila Micaela Escobar Liquitay; Michael Borofsky; Philipp Dahm Journal: World J Mens Health Date: 2021-08-04 Impact factor: 5.400
Authors: Juan Va Franco; Luis Garegnani; Camila Micaela Escobar Liquitay; Michael Borofsky; Philipp Dahm Journal: Cochrane Database Syst Rev Date: 2021-06-28
Authors: Rob A A van Kollenburg; Luigi A M J G van Riel; Paul R Bloemen; Jorg R Oddens; Theo M de Reijke; Harrie P Beerlage; Daniel Martijn de Bruin Journal: JMIR Res Protoc Date: 2020-01-21