Responders Versus Non-responders to Transurethral Microwave Thermotherapy in BPH: A Retrospective Analysis of Patient Profile

Yang, Kang Ho; Cho, Yong Hyun; Yoon, Moon Soo

Abstract

277 patients were investigated retrospectively to identify patient related parameters which could possibly correlate with a successful treatment outcome or to identify best responders to transurethral microwave thermotherapy(TUMT) with a minimum follow up of 6 months. Responders(R) were defined as having (1) symptom score(SS) decrease > 50% and maximal flow rate(MFR) increase > 50 % (> 15 ml/sec) or (2) symptom score decrease > 50% and residual urine volume(RU) decrease >50% (<50ml). Partial responders(PR) were defined as having 20-50% improvement in one of the parameters(SS, MFR, RU) in each of the two combined criteria of R group. Non-responders(NR) were defined as having (1) SS decrease <20% and MFR increase <20% (<10ml/sec) or (2) SS decrease < 20% and RU decrease <20% (>150ml). Each group was composed of 57, 71 and 108 patients respectively. Before TUMT, significant differences(p<0,05) were found in prostate volume(R:29.7 vs. PR:34. 2 vs. NR:38.0ml), prostatic urethral length(38.9 vs. 41.5 vs. 44.8mm) and history of acute retention(3/57 vs. 13/71 vs. 20/108) between R and NR group only. However, no significant differences were found in age(65.8 vs. 65.1 vs. 66.2), PSA(4.8 vs. 4.4 vs. 4.0ng/ml), Boyarsky symptom score(13.6 vs. 14.8 vs. 14.6), MFR(9.7 vs. 8.3 vs. 9.7ml/sec) and RU(86.4 vs. 78.6 vs. 67.8ml) between three groups. Conclusively, prostate volume(<30ml) and possibly prostatic urethral length(<38mm) in the absence of acute retention history seem to be correlated with relatively good clinical outcome and may be taken into consideration in our clinical setting.