Takahashi T, Tamaki M, Arai E, Sanada S
Department of Urology, Kansai Electric Power Hospital.
Hinyokika Kiyo. 1995 May;41(5):399-402.
The Prostatron device, developed by Dr. Devonec, provides microwave heating of the prostate and simultaneous conductive cooling of the urethra. Treatment with Prostatron (transurethral microwave thermotherapy: TUMT) of BPH can be performed in a single session, and the urethra, the rectum and the surrounding tissue are protected with the temperature monitoring system. TUMT with Prostatron may be more suitable for a small adenoma with mild symptoms than a large adenoma with severe symptoms, because objective improvement is rarely observed compared with subjective improvement. We have treated 40 cases of BPH with Prostatron (Prostasoft 2, max. energy: 50 watt, max. urethral temperature: 44.5 degrees C, max. rectal temperature: 42.5 degrees C) since March 1993. Among them, there were 2 cases of large cavity formation involving the prostatic urethra. With cavity formation, TUMT may have its place in the treatment of a large adenoma with severe urinary symptoms, but loses its advantage in the prevention of persistent urinary infection and retrograde ejaculation, especially in the treatment of a small adenoma in a younger patient with mild urinary symptoms. It is unknown why such cavity formation occurred only in 2 patients among 40 equally treated cases, but the causes of cavity formation and safety of TUMT should be evaluated again, even though no injury to the rectum and the external urethral sphincter were detected. We report these 2 cases, and causes of cavity formation and discuss the prospects of TUMT.
由德沃内克博士研发的前列腺治疗仪可对前列腺进行微波加热，并同时对尿道进行传导性冷却。采用前列腺治疗仪治疗良性前列腺增生（经尿道微波热疗：TUMT）可在单次治疗中完成，并且温度监测系统可对尿道、直肠及周围组织起到保护作用。对于症状较轻的小腺瘤，采用前列腺治疗仪进行TUMT可能比症状严重的大腺瘤更合适，因为与主观改善相比，客观改善情况很少见。自1993年3月以来，我们已采用前列腺治疗仪（Prostasoft 2，最大能量：50瓦，最高尿道温度：44.5摄氏度，最高直肠温度：42.5摄氏度）治疗了40例良性前列腺增生患者。其中，有2例出现累及前列腺尿道的大腔隙形成。出现腔隙形成的情况下，TUMT在治疗有严重排尿症状的大腺瘤方面可能有其用武之地，但在预防持续性尿路感染和逆行射精方面失去了优势，尤其是在治疗症状较轻的年轻患者的小腺瘤时。尚不清楚为何在40例接受相同治疗的患者中只有2例出现这种腔隙形成，但即使未检测到对直肠和尿道外括约肌的损伤，仍应再次评估腔隙形成的原因及TUMT的安全性。我们报告这2例病例，探讨腔隙形成的原因并讨论TUMT的前景。
