The safety and efficacy of transurethral microwave therapy in highrisk catheter-dependent men

Özet

Objective: Previous studies have demonstrated the efficacy of transurethral microwave therapy (TUMT)in the management of high-risk catheter-dependent men, although few have assessed safety in high-riskpatients, including those continuing anticoagulation therapy during treatment. Our goal was to assess thesafety and effectiveness of TUMT in a population of high-risk catheter-dependent men.Material and methods: A retrospective analysis of patients who underwent TUMT at a single VeteransAffairs facility for the treatment of benign prostatic hyperplasia was completed. The primary outcome was30-day postprocedural complications by Clavien-Dindo grade, including bleeding events. The secondaryoutcome was success in catheter removal.Results: We performed TUMT in 157 men, 105 of whom had urinary retention-requiring an indwellingurethral catheter or clean intermittent catheterization. Overall, 86% of patients underwent TUMT while onanticoagulant therapy and 25% were treated while taking warfarin. The median age of the patients was 76.9years (95% CI 74.9-78.8) median ASA-score was 3, and median follow-up was 26 months (range 1-65). Onlytwo men experienced hematuria requiring treatment postoperatively and no transfusions were required.Only two patients (1.9%) required readmission within 30 days after treatment. There were 24 (22.9%) Clavien-Dindo grade I-II complications without grade III or higher complications. Urinary retention resolvedin 63.7% of men after treatment.Conclusion: Our results suggest that TUMT is a safe and reasonably effective treatment for high-risk catheter-dependent men. Furthermore, the low incidence of adverse bleeding events suggests that TUMT is a safetreatment modality for men requiring uninterrupted anticoagulation.