Transurethral resection of the prostate vs high‐energy thermotherapy of the prostate in patients with benign prostatic hyperplasia: long‐term results

Objective To evaluate the outcome and durability of high‐energy transurethral microwave thermotherapy (HE‐TUMT) in comparison with transurethral resection of the prostate (TURP). Patients and methods Fifty‐two patients with BPH and lower urinary tract symptoms were randomized and treated either by TURP (21 patients; mean prostate volume 45 mL, sd 15) or HE‐TUMT (31 patients, mean prostate volume 43 mL, sd 12). Long‐term results were obtained at a mean (sd) follow‐up of 2.4 (0.5) years. Results During the follow‐up, the mean symptomatic improvement stabilized at 56% after TUMT and 74% after TURP. The mean maximum urinary flow rate increased by 62% after TUMT and 105% after TURP. Before treatment, 78% of patients in the TURP group were obstructed according to urodynamic investigation and after treatment, 14% remained obstructed. In the TUMT group, 67% of patients were obstructed before treatment and 33% remained so afterward. Six patients (19%) underwent TURP after TUMT (four after 1 year) and two patients were also treated with medication. One patient underwent a bladder neck incision after TURP to treat bladder neck sclerosis. Three patients were not satisfied with the outcome after the additional TURP. Conclusion Both treatment modalities show good symptomatic and objective results at >2 years of follow‐up. Most re‐treatments were performed ≥1 year after treatment and were based on subjective findings.