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Clinical Question:
Which is more effective technique for the treatment of Benign Prostatic
Hyperplasia (BPH),transurethral microwave thermotherapy (TUMT) alone or
combine TUMT and balloon dilatation (BD)?
Bottom Line:
Combined TUMT and BD achieves sufficient subjective and objective
improvement and a sustainable long-term effect. We consider this combination
technique to be useful for the treatment of prostatic hyperplasia.
Reference:
Treatment of benign prostatic hyperplasia using transurethral microwave
thermotherapy and dilatation with double-balloon catheter.Tsukada O,
Murakami M, Kosuge T, Yokoyama H.J Endourol. 2005 Oct;19(8):1016-20.
Study Design:
Randomized Trial
Synopsis:
To improve the outcome of transurethral microwave thermotherapy (TUMT) for
the treatment of benign prostatic hyperplasia, we combined TUMT and balloon
dilatation (BD) with a double-balloon catheter and investigated its effects.
For a short-term trial, 40 patients were divided randomly into two groups:
20 patients received TUMT alone, and the other 20 received TUMT followed by
BD. The degrees of symptoms were graded according to the International
Prostate Symptom Score and Quality of Life score, and the peak urinary flow
rate was measured before and 10 weeks after treatment. A historic control
study of 527 patients was also performed to evaluate the long-term
re-treatment rate: 98 of the patients received TUMT alone, and the other 429
patients received TUMT followed by BD. The symptom scores improved
significantly in both groups. The peak uroflow rate was significantly
increased in the group who received TUMT followed by BD (P < 0.01), whereas
the change was not significant in the TUMT-alone group. Significant
sustainability of long-term effects was more evident in patients receiving
TUMT plus BD than in the TUMT-alone group, as judged by the higher
proportion of BD-treated patients who required no further treatment during
the 5-year study period in comparison with patients who received TUMT alone
(66.3% v 28.6%, respectively; P < 0.001).
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