Skip to main content
Download PDF
  • Article Original
  • Open access
  • Published:

Résultats fonctionnels de la radiofréquence par Prostiva© dans le traitement de l’hypertrophie bénigne de la prostate (HBP) non compliquée résistante aux traitements médicamenteux

Functional results of radiofrequency by Prostiva© in the treatment of uncomplicated benign prostatic hypertrophy (BPH) resistant to drug treatments

Basic and Clinical Andrology volume 22, pages 227–232 (2012)Cite this article

Résumé

Objectif

Évaluer prospectivement les résultats fonctionnels de la thermothérapie prostatique par radiofréquence (Prostiva©) sur la gêne urinaire et la vie sexuelle dans le cadre du traitement d’une hypertrophie bénigne de la prostate (HBP) symptomatique non compliquée résistante aux traitements médicamenteux.

Patients et méthodes

Les patients répondant aux critères d’éligibilité à ce traitement édités selon la HAS ont été traités dans notre unité d’urologie. Ils ont été convoqués de façon systématique à un mois pour un examen clinique et paraclinique (débit urinaire maximum [Qmax], résidu postmictionnel [RPM], International Prostate Symptom Score [IPSS]). Ils ont été contactés en décembre 2009 et soumis à un hétéroquestionnaire téléphonique portant sur des scores de gêne urinaire (IPSS), de qualité de vie (question 8 de l’IPSS), d’évaluation des fonctions sexuelles (IIEF, DAN SEX), et d’évaluation subjective du traitement (échelle de Likert).

Résultats

De décembre 2006 à janvier 2009, 20 patients (âge médian: 63 ans) ont été traités par Prostiva©. Quatre patients ont présenté une rétention aiguë d’urine dans le postopératoire immédiat nécessitant un sondage vésical en urgence. Nous avons réalisé l’évaluation systématique de l’ensemble des patients à un mois et en décembre 2009. Le suivi médian était de 20,6 mois (valeurs maximales [12–37 mois]). On a constaté une amélioration significative de l’IPSS (−6,7 points; IC95= [−10,3; −3,1]), une amélioration des fonctions sexuelles, des scores de qualité de vie, et un sentiment d’amélioration globale des symptômes urinaires (+ 1,08 = amélioré sur l’échelle de Likert). Quatre patients ont été considérés comme des échecs du Prostiva©: trois patients ayant repris un traitement médicamenteux, un patient ayant bénéficié d’une résection de la prostate.

Conclusion

Notre étude monocentrique réalisée chez des patients sélectionnés selon les critères de l’HAS a conforté les résultats de la littérature avec des résultats positifs sur la gêne urinaire, une faible morbidité et une amélioration de la qualité de vie déclarée. Elle a démontré l’innocuité de la thermothérapie sur la sexualité des patients et mieux encore, l’impact positif du traitement sur la qualité des érections et la satisfaction des rapports.

Abstract

Objective

To assess prospectively on objective and subjective parameters functional outcomes of prostatic thermotherapy by radiofrequency (Prostiva©) on urinary discomfort and sexual life in the treatment of uncomplicated symptomatic and resistant to drug treatment benign prostatic hypertrophy (BPH).

Patients and methods

Patients with eligibility criteria for this treatment published by HAS have been treated in our urology unit. They were called at one month for a clinical examination and analysis of objective data (maximum urine flow [Qmax], post-voiding residual, international prostate score symptom [IPSS]). They were contacted in December 2009 and submitted to a questionnaire on urinary symptoms (IPSS), quality of life (question 8 of IPSS), assessment of sexual function (IIEF, DAN SEX) and subjective assessment of treatment (Likert score).

Results

From December 2006 to January 2009, 20 patients (median age: 63 years) were treated with Prostiva©. Four patients had acute retention of urine in the immediate postoperative needing a urinary catheterization in emergency. We made a systematic evaluation of all patients at one month and in December 2009. The median follow-up was 20.6 months (12–37 months). There was a significant improvement of IPSS (−6.7 points; IC95= [−10.3; −3.1]), an improvement of sexuality functions, quality of life data, and a sense of global improvement of urinary symptoms (+ 1.8 = improved on the Likert score). Four patients were considered as failures: three patients resumed drug therapy, one patient received a prostate resection.

Conclusion

Our single centre study performed in selected patients according to the criteria of HAS consolidated the results of published studies. Results were positive on urinary symptoms, with a low morbidity and a positive subjective evaluation on symptoms. It demonstrated the safety of thermotherapy on patients’ sexuality and even better, the positive impact of the treatment on erections and satisfaction relations.

Références

  1. Descazeaud A, Robert G, Delongchamps NB, et al (2012) Initial assessment and follow-up of benign prostatic hyperplasia: systematic review of the literature by the LUTS committee of the French Urological Association. Prog Urol 22:1–6

    Article  PubMed  CAS  Google Scholar 

  2. Doublet JD, David DJ (2006) Traitement de l’hypertrophie bénigne de la prostate par radiofréquence ou micro-ondes. Rapport de la Haute Autorité de Santé (HAS)

  3. Barry Delongchamps N, Robert G, Descazeaud A, et al (2012) Surgical management of benign prostatic hyperplasia by thermotherapy and other emerging techniques: A review of the literature by the LUTS committee of the French Urological Association. Prog Urol 22:87–92

    Article  PubMed  CAS  Google Scholar 

  4. Desgrandchamps F, de Gouvello A, Mongiat-Artus P, et al (2008) Traitement d’une hypertrophie bénigne de la prostate par radiofréquences. In: Encyclopédie médico-chirurgicale (EMC), Techniques chirurgicales; Urologie. Elsevier Masson SAS, Paris, pp 41–274-B

    Google Scholar 

  5. Minardi D, Galosi AB, Yehia M, et al (2004) Transurethral resection versus minimally invasive treatments of benign prostatic hyperplasia: results of treatments. Our experience. Arch Ital Urol Androl 76:11–18

    PubMed  Google Scholar 

  6. Daehlin L, Gustavsen A, Nilsen AH, Mohn J (2002) Transurethral needle ablation for treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia: outcome after one year. J Endourol 16:111–115

    Article  PubMed  Google Scholar 

  7. Holmes MA, Stewart J, Boulton JB, Chambers RM (1999) Transurethral needle ablation of the prostate: outcome at 1 year. J Endourol 13:745–750

    Article  PubMed  CAS  Google Scholar 

  8. Minardi D, Garofalo F, Yehia M, et al (1998) Transurethral needle ablation (TUNA) in benign prostatic hypertrophy: 2-year follow-up. Arch Ital Urol Androl 70(3 Suppl):11–13

    PubMed  CAS  Google Scholar 

  9. Savoie PH, Lopez L, Simonin O, et al (2009) Two-years followup of radiofrequency thermotherapy for urination disorders due to benign prostatic hyperplasia. Prog Urol 19:501–506

    Article  PubMed  Google Scholar 

  10. Hill B, Belville W, Bruskewitz R, et al (2004) Transurethral needle ablation versus transurethral resection of the prostate for the treatment of symptomatic benign prostatic hyperplasia: 5-year results of a prospective, randomized, multicenter clinical trial. J Urol 171(6 Pt 1):2336–2340

    Article  PubMed  Google Scholar 

  11. Zlotta AR, Giannakopoulos X, Maehlum O, et al (2003) Longterm evaluation of transurethral needle ablation of the prostate (TUNA) for treatment of symptomatic benign prostatic hyperplasia: clinical outcome up to five years from three centers. Eur Urol 44:89–93

    Article  PubMed  Google Scholar 

  12. Boyle P, Robertson C, Vaughan ED, Fitzpatrick JM (2004) A meta-analysis of trials of transurethral needle ablation for treating symptomatic benign prostatic hyperplasia. BJU Int 94:83–88

    Article  PubMed  Google Scholar 

  13. Fouques Y, Mallick S, Frachet O, et al (2007) Evaluation of radiofrequency (TUNA) in the outpatient treatment of benign prostatic hyperplasia. Prog Urol 17:824–827

    Article  PubMed  Google Scholar 

  14. Le Gal S, Fouques Y, Mallick S, et al (2009) Treatment of benign prostatic hyperplasia by radiofrequency (TUNA): a monocentric study of 28 cases treated in ambulatory surgery. Prog Urol 19:327–332

    Article  PubMed  Google Scholar 

  15. Martin X, Claude A, Colombel M, et al (2005) Treatment of benign prostatic hyperplasia (BPH) by transurethral needle ablation (TUNA) and 36-month follow-up of the retreatment rate. Prog Urol 15:674–680

    PubMed  Google Scholar 

  16. Bouza C, López T, Magro A, et al (2006) Systematic review and meta-analysis of transurethral needle ablation in symptomatic benign prostatic hyperplasia. BMC Urol 6:14

    Article  PubMed  PubMed Central  Google Scholar 

  17. Cimentepe E, Unsal A, Saglam R (2003) Randomized clinical trial comparing transurethral needle ablation with transurethral resection of the prostate for the treatment of benign prostatic hyperplasia: results at 18 months. J Endourol 17:103–107

    Article  PubMed  Google Scholar 

  18. Naslund MJ, Carlson AM, Williams MJ (2005) A cost comparison of medical management and transurethral needle ablation for treatment of benign prostatic hyperplasia during a 5-year period. J Urol 173:2090–2093

    Article  PubMed  CAS  Google Scholar 

  19. Zani EL, Netto NR Jr (2007) Is the minimally invasive treatment as good as transurethral resection for benign prostatic hyperplasia? Int Urol Nephrol 39:161–168

    Article  PubMed  Google Scholar 

  20. Arai Y, Aoki Y, Okubo K, et al (2000) Impact of interventional therapy for benign prostatic hyperplasia on quality of life and sexual function: a prospective study. J Urol 164:1206–1211

    Article  PubMed  CAS  Google Scholar 

  21. Frieben RW, Lin H, Hinh PP, et al (2010) The impact of minimally invasive surgeries for the treatment of symptomatic benign prostatic hyperplasia on male sexual function: a systematic review. Asian J Androl 12:500–508

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Service d’urologie, centre hospitalier Victor Dupouy d’Argenteuil, 69 rue du Lieutenant-Colonel Prudhon, F-95107, Argenteuil, France

    J. Jean-Baptiste

  2. Service d’urologie, hôpital Saint-Louis, 10 avenue Claude Vellefaux, F-75010, Paris, France

    P. Meria & F. Desgrandchamps

Authors
  1. J. Jean-Baptiste
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. P. Meria
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. F. Desgrandchamps
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. Jean-Baptiste.

Rights and permissions

Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/2.0 ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Reprints and permissions

About this article

Cite this article

Jean-Baptiste, J., Meria, P. & Desgrandchamps, F. Résultats fonctionnels de la radiofréquence par Prostiva© dans le traitement de l’hypertrophie bénigne de la prostate (HBP) non compliquée résistante aux traitements médicamenteux. Basic Clin. Androl. 22, 227–232 (2012). https://doi.org/10.1007/s12610-012-0197-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12610-012-0197-9

Mots clés

Keywords

Basic and Clinical Andrology

ISSN: 2051-4190