Okada K, Yoshida T, Endo M, Aoki Y, Ikeya T, Yoshikawa T, Hirakata H, Ohi T, Kobayashi M, Kiyotaki S
Department of Urology, Nihon University School of Medicine.
Nihon Hinyokika Gakkai Zasshi. 1991 Mar;82(3):455-61. doi: 10.5980/jpnjurol1989.82.455.
Though the local hyperthermia for the management of benign prostatic hyperplasia has drawn much attention as one non-surgical treatment, no definite conclusion could yet be obtained in terms of the efficacy. In this study local hyperthermia was induced in evaluable 33 cases with benign prostatic hyperplasia using Primus, and the effectiveness of this modality of treatment was investigated by analysing the subjective and objective response following hyperthermia. The prostate was heated trans-rectally up to 43 degrees C with 915 MHz microwave for one hour. Hyperthermia was carried out twice a week for ten times for the sake of thermotolerance. Urinary obstructive symptoms were divided into diurnal and nocturnal frequency, urinary urgency, the degree of urinary stream, hesitancy and dribbling. Each symptom was described before and after the treatment according to the scoring system. Moreover, objective changes of urinary flow and prostatic size were estimated by the residual urine volume, uro-flowmetry, rectal palpation of the prostate and echography. Hyperthermic treatment improved urinary flow markedly, but no appreciable alteration could be observed as to the size of the prostate. The overall efficacy, including subjective and objective response, could be summarized as 37% of effectiveness, and 33% of slight effectiveness, that is, 70% of effective ratio. As to the side effect, anal pain was noted in few cases of the present series. Therefore, transrectal hyperthermia may be a suitable modality for non-surgical treatment of benign prostatic hyperplasia.
尽管局部热疗作为一种非手术治疗良性前列腺增生的方法已备受关注，但在疗效方面尚未得出明确结论。在本研究中，使用Primus对33例可评估的良性前列腺增生患者进行局部热疗，并通过分析热疗后的主观和客观反应来研究这种治疗方式的有效性。通过915兆赫微波经直肠将前列腺加热至43摄氏度，持续1小时。为了防止热耐受，每周进行两次热疗，共十次。尿路梗阻症状分为日间和夜间尿频、尿急、尿流程度、排尿犹豫和滴沥。根据评分系统在治疗前后描述每种症状。此外，通过残余尿量、尿流率测定、前列腺直肠触诊和超声检查来评估尿流和前列腺大小的客观变化。热疗显著改善了尿流，但前列腺大小未见明显改变。包括主观和客观反应在内的总体疗效可总结为有效率37%，轻度有效率33%，即总有效率70%。关于副作用，本系列中少数病例出现肛门疼痛。因此，经直肠热疗可能是良性前列腺增生非手术治疗的一种合适方式。
