Transrectal Prostatic Hyperthermia and Urinary Retention Secondary to Benign Prostatic Hyperplasia: A 2-Year Follow-Up Study

This study evaluated retrospectively the long-term effect of transrectal hyperthermia on urinary retention caused by benign prostatic hyperplasia (BPH) in 35 patients noncligible for surgical treatment. A catheter had been in place for at least 3 months in all the patients. Patients were evaluated with medical history, physical examination, laboratory analysis, intravenous urography, transrectal ultrasonography, uroflowmetry, and rectoscopy. Prostatic hyperthermia was delivered transrectally in ten 60-minute sessions with a calculated intraprostatic temperature of 43 ± 0.5°C. At the 2-year follow-up, 18 patients (52%) were still able to void spontaneously with a mean residual urine volume of 60 ± 30 (SD) ml and a mean peak flow rate of 13.5 ± 3.6 ml/sec. Twleve patients could not be weaned off the catheter at the end of treatment, and in five patients, the catheter had to be replaced during the first postoperative year. Age, preoperative prostatic volume, preoperative prostatic length, and thermal equivalent dose delivered to the prostate were evaluated with the Mann-Whitney test, and no statistical difference was noted between responders and failures even if the thermal equivalent dose was higher in responders.