Can microwave therapy replace surgical resection?

This study evaluated the benefits and harms of microwave thermotherapy in the treatment of benign prostatic hyperplasia (BPH) and urinary symptoms.

Benign prostatic hyperplasia may lead to troublesome urinary symptoms, often requiring surgical intervention. A procedure called transurethral resection of the prostate (TURP) is considered standard treatment for BPH. However, TURP is associated with many complications. Therefore, less invasive techniques have been developed. Microwave thermotherapy applies microwave energy (heat) to shrink enlarged prostatic tissue.

Fifteen studies, including a total of 1585 men, were included in this analysis.

Compared to a sham (fake) procedure, microwave therapy improved urine flow and reduced urinary symptoms. Microwave therapy was also more effective than alpha-blocker drug therapy in improving urine flow and patient reported quality of life. However, TURP produced greater improvements in urinary symptoms and urine flow than microwave therapy. Fewer men undergoing TURP required future BPH treatment.

Microwave therapy was associated with less unwanted complications compared to TURP. A decreased risk was noted for internal scarring, hematuria (bloody urine), and the need for blood transfusions. However, TURP was associated with a lower likelihood of dysuria (pain during urination) and urinary retention (an inability to pass urine).

This analysis concluded that microwave thermotherapy is an effective alternative to TURP and alpha-blockers for treating BPH symptoms in men. However, TURP provided greater improvements and reduced the need for subsequent BPH treatment.