Baba S, Nakamura K, Tachibana M, Murai M
Department of Urology, Keio University School of Medicine, Tokyo, Japan.
Urology. 1996 May;47(5):664-71. doi: 10.1016/s0090-4295(96)00012-x.
The durability of clinical efficacy of transurethral microwave thermotherapy (TUMT) by Prostatron using a low-energy protocol (maximum power, 50 W) was evaluated on an outpatient basis in patients with symptomatic benign prostatic hyperplasia (BPH).
One hundred eighteen patients were followed up for longer than 3 months (13.4 +/- 9.5 months; mean +/- SD). All evaluations were made at baseline and then 3, 6, 12, 24, and 36 months after therapy.
International Prostate Symptom Score (IPSS) significantly decreased from 18.2 to 10.6 at 6 months (P < 0.01), representing a mean improvement of 41% under the baseline. Peak flow rate increased from the baseline of 8.3 mL/s to 10.3 mL/s at 6 months (P < 0.01). The improvement in terms of mean values of both parameters was sustained up to 24 months. Six of 44 patients (14%) who were followed up for 31 months on average required transurethral resection of the prostate for recurring obstructive symptoms and 10 additional patients (23%) had to be treated with various drug regimens. When the clinical outcome was evaluated in terms of improvement from the baseline according to a response criteria, disease-free rates for IPSS (more than 25% improvement from the baseline) were 76% at 12 months, 77% at 24 months, and 61% at 36 months. Disease-free rate for peak flow rate (more than 2.5 mL/s from the baseline) was sustained in 44% by 12 months and in 48% by 24 months. The overall outcome of the treatment was assessed by adding scores based on both subjective and objective efficacy criteria. At 6 months, 67% of the patients were responders, and 15 of 21 (71%) remained as responders at 24 months. Patients who had estimated prostate volume smaller than 30 cc showed more marked improvement in peak flow rate (P < 0.02), and those with baseline IPSS of 20 or more showed greater reduction of IPSS (P < 0.05) at 24 months compared with each counterpart.
After TUMT with a low-energy protocol, satisfactory results were obtained and the improvement seems to last at least for 24 months. This low-energy protocol may be most beneficial in patients with relatively small size of the prostate.
在门诊对有症状的良性前列腺增生（BPH）患者采用低能量方案（最大功率50W）的Prostatron经尿道微波热疗（TUMT）的临床疗效持久性进行评估。
118例患者随访时间超过3个月（13.4±9.5个月；均值±标准差）。所有评估均在基线时以及治疗后3、6、12、24和36个月进行。
国际前列腺症状评分（IPSS）在6个月时从18.2显著降至10.6（P<0.01），较基线平均改善41%。峰值尿流率在6个月时从基线的8.3mL/s增至10.3mL/s（P<0.01）。这两个参数均值的改善持续至24个月。44例平均随访31个月的患者中有6例（14%）因复发性梗阻症状需要行经尿道前列腺切除术，另有10例患者（23%）必须接受各种药物治疗。根据反应标准以较基线的改善情况评估临床结局时，IPSS的无病率（较基线改善超过25%）在12个月时为76%，24个月时为77%，36个月时为61%。峰值尿流率的无病率（较基线增加超过2.5mL/s）在12个月时维持在44%，24个月时维持在48%。根据主观和客观疗效标准加分评估治疗的总体结局。6个月时，67%的患者有反应，21例中有15例（71%）在24个月时仍有反应。前列腺估计体积小于30cc的患者峰值尿流率改善更明显（P<0.02），与各自对照组相比，基线IPSS为20或更高的患者在24个月时IPSS降低更显著（P<0.05）。
采用低能量方案进行TUMT后，获得了满意的结果，且改善似乎至少持续24个月。这种低能量方案可能对前列腺体积相对较小的患者最为有益。
