Long-Term Results of Bipolar Radiofrequency Needle Ablation of the Prostate for Lower Urinary Tract Symptoms

Abstract

Purpose:

To report the first long-term experience on the efficacy of bipolar transurethral radiofrequency needle ablation (RFA) in patients with lower urinary tract symptoms that are secondary to benign prostatic hyperplasia.

Patients and Methods:

A nonrandomized prospective cohort of 12 candidates for transurethral resection of the prostate underwent bipolar transurethral RFA in 2004 (mean age 63; prostate volume 34 cc). Patients were evaluated preoperatively and at 3, 12, 36, and 60 months postprocedure. International Prostate Symptom Score (IPSS), quality-of-life (QoL) index, peak urinary flow rate (Q_max), postvoid residual volume (PVR), and need for a second procedure were evaluated at each follow-up interval.

Results:

Significant improvement in urinary symptoms and voiding parameters occurred at 1 year after the procedure. Mean improvements for IPSS, QoL, and Q_max were 12 points, 3.5 points, and 8 mL/s, respectively. Improvement, however, was not sustained in the long term. Nine patients ultimately had treatment failure necessitating a secondary procedure, one at 2 months, five after 3 years, and three by 5 years. Two patients were lost to follow-up. Only one patient had long-term benefit from the procedure.

Conclusion:

In the short term, bipolar RFA produced clinically meaningful improvement in symptom scores and voiding parameters. The majority of patients, however, eventually experienced treatment failure and needed additional surgical procedures. Only 8% of patients had long-term (>5 years) benefit.