A review of the effects of transurethral microwave thermotherapy (TUMT) for lower urinary tract symptoms (LUTS) in men with benign prostate hyperplasia

In the last decade of the new millennium, it can be seen that the number of transurethral microwave thermotherapy (TUMT) treatments has decreased significantly. Investigating the reasons for this trend, it was decided to review the literature data on TUMT. This review mainly focuses on the effectiveness of TUMT on lower urinary tract symptoms (LUTS) and the impact on erectile function (EF). The reference method was transurethral resection of the prostate (TURP). MEDLINE, EMBASE, Scopus and Cochrane Library databases between 1991–2021 were searched to identify studies on TUMT. The review included both randomized controlled trials and non-randomized trials; 55 items were selected for further analysis. They included 13 randomized reports, 1 non-randomized report and 8 reviews. Surprisingly, data analysis shows that TUMT is almost as effective in reducing LUTS as TURP. However, significant differences in complication profiles were noted. Transurethral microwave thermotherapy showed negligible morbidity and no serious complications compared to TURP. Transurethral microwave thermotherapy is also characterized by a slight influence on erectile dysfunction and retrograde ejaculation in contrast to TURP. Two facts of TUMT draw attention: the lack of precise qualification criteria and too few randomized controlled trials. Despite the critical attitude of some researchers to TUMT, it seems to be a valuable method and a suitable alternative to TURP. However, further research is needed with an increasing number of randomized controlled trials. This review aims to discuss the effects on EF of TUMT for LUTS in men with benign prostate hyperplasia.