Türk Yaşar, Devecioğlu İsmail, Çilesiz Nusret Can, Nuhoğlu Barış
Kolan International Hospital, Clinic of Radiology, İstanbul, Turkey.
Tekirdağ Namık Kemal University, Çorlu Faculty of Engineering, Department of Biomedical Engineering, Tekirdağ, Turkey.
Diagn Interv Radiol. 2025 Mar 3;31(2):141-145. doi: 10.4274/dir.2024.232639. Epub 2024 Feb 29.
Transperineal prostate microwave thermoablation (TPMT) has been established as a safe means of treating benign prostatic hyperplasia (BPH); however, its effectiveness in addressing BPH-related lower urinary tract symptoms (LUTS) remains unexplored. This case study aims to evaluate the efficacy of TPMT in LUTS attributed to BPH. An 84-year-old man with LUTS due to BPH-induced bladder outlet obstruction, unresponsive to previous medical treatments, and failed prostate artery embolization, underwent TPMT. Three coaxial needles were positioned at the midline, right, and left sides of the hypertrophic transitional zone of the prostate. Microwave energy, with parameters determined using liver data and targeted ablation area, was applied at 2,450 MHz in continuous mode. The tissue temperature was monitored using bilateral thermocouple sensors. The patient exhibited no changes in defecation rhythm, abdominal discomfort, or anorectal pain. Temporary postoperative hematuria was promptly resolved through saline irrigation within 6 hours, and hematological evaluations showed normal results. Significant clinical improvements were observed (e.g., prostate volume, prostate-specific antigen levels) accompanied by an increase in peak flow rate. Thus, TPMT appears to be a promising intervention for bladder outlet stenosis and LUTS induced by BPH.
经会阴前列腺微波热消融术（TPMT）已被确立为治疗良性前列腺增生（BPH）的一种安全方法；然而，其在解决BPH相关下尿路症状（LUTS）方面的有效性仍未得到探索。本病例研究旨在评估TPMT对BPH所致LUTS的疗效。一名84岁男性因BPH引起膀胱出口梗阻导致LUTS，对先前的药物治疗无反应且前列腺动脉栓塞术失败，接受了TPMT。三根同轴针分别置于前列腺增生移行带的中线、右侧和左侧。根据肝脏数据和目标消融区域确定参数，以2450 MHz的频率在连续模式下施加微波能量。使用双侧热电偶传感器监测组织温度。患者的排便节律、腹部不适或肛门直肠疼痛均无变化。术后短暂血尿通过6小时内的生理盐水冲洗迅速得到解决，血液学评估结果正常。观察到显著的临床改善（如前列腺体积、前列腺特异性抗原水平），同时最大尿流率增加。因此，TPMT似乎是治疗BPH引起的膀胱出口狭窄和LUTS的一种有前景的干预措施。
