APPLICATION OF TRANSURETHRAL MICROWAVE THERMOTHERAPY FOR PATIENTS WITH ACUTE URINARY RETENTION AND SEVERE COMBINED COMORBIDITY FROM BENIGN PROSTATIC HYPERPLASIA
AbstractBackground. The incidence of benign prostatic hyperplasia (BPH) has grown by almost 35 % over the last five years with an incidence rate of 4438,2 per 100 000 of the respective population (147 677 total patients) in Ukrainian men beyond working age in 2007 .
Objective. The aim of the study was to assess the efficacy of TUMT in men where BPH was complicated by AUR and severe comorbidities.
Method. TUMT was performed using the domestically produced equipment ‘ALMGP-01’ at the frequency of 1300 Hz, rectal temperature of 42.5 °C, and urethral temperature of 44.5 °C. The average session duration is 46-55 minutes.
Results and Discussion. Subjective self-assessment: no effect of the procedure was detected (urination not restored) in 9 patients (11.11 %); poor current status with prior temporary improvement (6-9 months of independent urination with repeated AUR) in 14 patients (17.28 %); satisfactory current status with occasional dysuric episodes (however better than pre-TUMT status) in 40 patients (49.38 %). Eight patients (22.22 %) have assessed their status as ‘good’ and ‘excellent’; one patient noted substantial improvement compared to pre-procedure status. The nine patients with lack of success of restoring physiological urination had the following peculiarities: intra-vesical growth of BPH and prostatic volume over 85 cm3 in majority of these patients.
Conclusions. Taking into consideration the minimally invasive nature, favourable tolerability and absence of adverse effects, TUMT can be considered a method of choice in patients with BPH-triggered AUR and contraindications to major surgical treatments and general anaesthesia. Remote outcomes of TUMT may be evaluated as satisfactory, with good effects in 71.62% patients. However in prostatic volumes exceeding 85 cm3 and pronounced intravesical pattern of BPH growth the efficcacy of TUMT is arguable.
KEY WORDS: benign prostatic hyperplasia, acute urinary retention, transurethral microwave hermotherapy.
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