Brehmer M, Baba S
Department of Urology, Huddinge University Hospital, Sweden.
J Endourol. 2000 Oct;14(8):611-5. doi: 10.1089/end.2000.14.611.
Although some authors have proposed that the favorable impact of transurethral microwave thermotherapy (TUMT) for benign prostatic hyperplasia has only a placebo effect, this idea is inconsistent with the findings of a number of sham-controlled clinical trials. Histologic and immunohistochemical studies have shown that the nerve fibers in the periurethral tissue are damaged or ablated by TUMT, and it appears that the heat affects the innervation of the smooth muscle cells. Among the nerves damaged are the sensory neurons of the posterior urethra, and this change might reduce the excitatory signals from the urethrodetrusor facilitating reflexes. Necrosis and apoptosis within a limited area also have been described. Thus, there is likely more than one basis for the therapeutic effect of TUMT.
尽管一些作者提出经尿道微波热疗（TUMT）对良性前列腺增生的有利影响只是安慰剂效应，但这一观点与多项假手术对照临床试验的结果不一致。组织学和免疫组化研究表明，TUMT会损伤或消融尿道周围组织中的神经纤维，而且热似乎会影响平滑肌细胞的神经支配。受损的神经包括后尿道的感觉神经元，这种变化可能会减少来自尿道逼尿肌的兴奋性信号，从而促进反射。有限区域内的坏死和凋亡也有相关描述。因此，TUMT的治疗效果可能有不止一种依据。
