Transurethral hot-water balloon thermoablation for benign prostatic hyperplasia: Patient tolerance and pathologic findings

Federico A. Corica, Liang Cheng, Dharamdas Ramnani, Anna Pacelli, Amy Weaver, Alberto P. Corica, Alberto G. Corica, Thayne R. Larson, Kathylin O'Toole, David G. Bostwick

Research output: Contribution to journalArticle

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Abstract

Objectives. To determine the patient tolerance and thermal ablation pattern in human prostatic tissue after treatment with a hot water, catheter- based system. Methods. Twenty-seven men scheduled for surgery for symptomatic benign prostatic hyperplasia or adenocarcinoma of the prostate underwent water-induced thermotherapy. The patients were randomly assigned to one of four treatment groups. Lidocaine gel was the sole means of pain control. The patients and an observer recorded patient discomfort during therapy. A Foley catheter was left in place until surgery (n = 13) or successful voiding (n = 14). Prostates were subsequently enucleated or removed, whole mounted, and examined. Results. Patients reported mild treatment discomfort, the level of which did not correlate with the extent of necrosis, balloon diameter, or water temperature (all P >0.05). Distal penile burning was the most commonly reported discomfort. All 14 patients successfully voided within 12 days of treatment. Prostates were enucleated (n = 24) or removed (n = 3) at a mean of 27 days (range 4 to 120) after thermotherapy, except for a single adenectomy 17 months after therapy. Pathologic findings included periurethral hemorrhagic necrosis, with focal or extensive urothelial denudation and mild inflammation. The mean maximal depth of necrosis from the urethral lumen was 7, 9, 10.33, and 11 mm in groups 1, 2, 3, and 4, respectively. The extent of necrosis was similar in all groups (P = 0.11), regardless of the water temperature; conversely, the balloon diameter correlated with the depth of necrosis (P = 0.024). Conclusions. This system of tissue ablation appears to be well tolerated, and it produced consistent pathologic results. (C) 2000 Elsevier Science Inc.

Original languageEnglish
Pages (from-to)76-81
Number of pages6
JournalUrology
Volume56
Issue number1
DOIs
StatePublished - Jul 2000

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Prostatic Hyperplasia
Necrosis
Water
Prostate
Induced Hyperthermia
Therapeutics
Catheters
Temperature
Lidocaine
Adenocarcinoma
Hot Temperature
Gels
Inflammation
Pain

ASJC Scopus subject areas

  • Urology

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Transurethral hot-water balloon thermoablation for benign prostatic hyperplasia : Patient tolerance and pathologic findings. / Corica, Federico A.; Cheng, Liang; Ramnani, Dharamdas; Pacelli, Anna; Weaver, Amy; Corica, Alberto P.; Corica, Alberto G.; Larson, Thayne R.; O'Toole, Kathylin; Bostwick, David G.

In: Urology, Vol. 56, No. 1, 07.2000, p. 76-81.

Research output: Contribution to journalArticle

Corica, FA, Cheng, L, Ramnani, D, Pacelli, A, Weaver, A, Corica, AP, Corica, AG, Larson, TR, O'Toole, K & Bostwick, DG 2000, 'Transurethral hot-water balloon thermoablation for benign prostatic hyperplasia: Patient tolerance and pathologic findings', Urology, vol. 56, no. 1, pp. 76-81. https://doi.org/10.1016/S0090-4295(00)00542-2
Corica, Federico A. ; Cheng, Liang ; Ramnani, Dharamdas ; Pacelli, Anna ; Weaver, Amy ; Corica, Alberto P. ; Corica, Alberto G. ; Larson, Thayne R. ; O'Toole, Kathylin ; Bostwick, David G. / Transurethral hot-water balloon thermoablation for benign prostatic hyperplasia : Patient tolerance and pathologic findings. In: Urology. 2000 ; Vol. 56, No. 1. pp. 76-81.
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T1 - Transurethral hot-water balloon thermoablation for benign prostatic hyperplasia

T2 - Patient tolerance and pathologic findings

AU - Corica, Federico A.

AU - Cheng, Liang

AU - Ramnani, Dharamdas

AU - Pacelli, Anna

AU - Weaver, Amy

AU - Corica, Alberto P.

AU - Corica, Alberto G.

AU - Larson, Thayne R.

AU - O'Toole, Kathylin

AU - Bostwick, David G.

PY - 2000/7

Y1 - 2000/7

N2 - Objectives. To determine the patient tolerance and thermal ablation pattern in human prostatic tissue after treatment with a hot water, catheter- based system. Methods. Twenty-seven men scheduled for surgery for symptomatic benign prostatic hyperplasia or adenocarcinoma of the prostate underwent water-induced thermotherapy. The patients were randomly assigned to one of four treatment groups. Lidocaine gel was the sole means of pain control. The patients and an observer recorded patient discomfort during therapy. A Foley catheter was left in place until surgery (n = 13) or successful voiding (n = 14). Prostates were subsequently enucleated or removed, whole mounted, and examined. Results. Patients reported mild treatment discomfort, the level of which did not correlate with the extent of necrosis, balloon diameter, or water temperature (all P >0.05). Distal penile burning was the most commonly reported discomfort. All 14 patients successfully voided within 12 days of treatment. Prostates were enucleated (n = 24) or removed (n = 3) at a mean of 27 days (range 4 to 120) after thermotherapy, except for a single adenectomy 17 months after therapy. Pathologic findings included periurethral hemorrhagic necrosis, with focal or extensive urothelial denudation and mild inflammation. The mean maximal depth of necrosis from the urethral lumen was 7, 9, 10.33, and 11 mm in groups 1, 2, 3, and 4, respectively. The extent of necrosis was similar in all groups (P = 0.11), regardless of the water temperature; conversely, the balloon diameter correlated with the depth of necrosis (P = 0.024). Conclusions. This system of tissue ablation appears to be well tolerated, and it produced consistent pathologic results. (C) 2000 Elsevier Science Inc.

AB - Objectives. To determine the patient tolerance and thermal ablation pattern in human prostatic tissue after treatment with a hot water, catheter- based system. Methods. Twenty-seven men scheduled for surgery for symptomatic benign prostatic hyperplasia or adenocarcinoma of the prostate underwent water-induced thermotherapy. The patients were randomly assigned to one of four treatment groups. Lidocaine gel was the sole means of pain control. The patients and an observer recorded patient discomfort during therapy. A Foley catheter was left in place until surgery (n = 13) or successful voiding (n = 14). Prostates were subsequently enucleated or removed, whole mounted, and examined. Results. Patients reported mild treatment discomfort, the level of which did not correlate with the extent of necrosis, balloon diameter, or water temperature (all P >0.05). Distal penile burning was the most commonly reported discomfort. All 14 patients successfully voided within 12 days of treatment. Prostates were enucleated (n = 24) or removed (n = 3) at a mean of 27 days (range 4 to 120) after thermotherapy, except for a single adenectomy 17 months after therapy. Pathologic findings included periurethral hemorrhagic necrosis, with focal or extensive urothelial denudation and mild inflammation. The mean maximal depth of necrosis from the urethral lumen was 7, 9, 10.33, and 11 mm in groups 1, 2, 3, and 4, respectively. The extent of necrosis was similar in all groups (P = 0.11), regardless of the water temperature; conversely, the balloon diameter correlated with the depth of necrosis (P = 0.024). Conclusions. This system of tissue ablation appears to be well tolerated, and it produced consistent pathologic results. (C) 2000 Elsevier Science Inc.

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