Effect of bipolar radiofrequency thermotherapy on benign prostate hyperplasia

Non-Invasive Radiofrequency Hyperthermia Attenuates HMGB1/TLR4/NF-κB Inflammatory Axis in a Chronic Prostatitis/Chronic Pelvic Pain Syndrome Rat Model

PURPOSE

The primary goal of this study is to evaluate the effect of the non-invasive radiofrequency hyperthermia (RFHT) device on chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) rat model and investigate the underlying mechanism.

MATERIALS AND METHODS

In this study, Sprague-Dawley rats were randomly distributed into three groups: (1) normal control group, (2) CP/CPPS group, and (3) RFHT group. CP/CPPS rat models were induced by 17β-estradiol and dihydrotestosterone for 4 weeks and RFHT was administered for 5 weeks after model establishment. During RFHT administration, core body temperatures were continuously monitored with a rectal probe. After administering RFHT, we assessed pain index for all groups and collected prostate tissues for Western blot analysis, immunofluorescence, and immunohistochemistry. We also collected adjacent organs to the prostate including urinary bladder, testes, and rectum for safety assessment via H&E staining along with a terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling assay.

RESULTS

After administering RFHT, pain in rats was significantly alleviated compared to the CP/CPPS group. RFHT reduced high-mobility group box 1 (HMGB1) expression and improved inflammation by downregulating subsequent proinflammatory cytokines through inhibition of the toll-like receptor 4 (TLR4)-nuclear factor kappa B (NF-κB) pathway. In prostate-adjacent organs, no significant histological alteration or inflammatory infiltration was detected. The area of cell death also did not increase significantly after RFHT.

CONCLUSIONS

In conclusion, RFHT demonstrated anti-inflammatory effects by inhibiting the HMGB1-TLR4-NF-κB pathway in CP/CPPS rat models. This suggests that RFHT could serve as a safe and promising therapeutic strategy for CP/CPPS.

Can transurethral thermotherapy save elderly patients with benign prostatic obstruction and high ASA score?

INTRODUCTION

The Aim of this study was to investigate the efficacy of the new bipolar radiofrequency prostate thermotherapy method for those with high potential surgical risk and also for patients with a chronic catheter.

MATERIAL AND METHODS

103 patients attending our clinic due to BPO and related complaints with high ASA score had outcomes after the procedure recorded prospectively and investigated retrospectively. Qmax, prostate volume, IPSS score, quality of life score, and presence of catheters were recorded before the procedure and analyzed with the outcomes after the procedure.

RESULTS

The ASA scores were calculated as 3.0 ± 1.0 (IQR). Before the procedure, Qmax values (mean (SD)) were 5.11 ± 5.37 ml/s, while in the 6th month after the procedure Qmax values were identified as 10.45 ± 3.8 ml/s (p < 0.001). Of 53 patients (55.2%) with chronic catheters who could not be operated, 30 (61.2%) no longer required urinary catheter.

CONCLUSION

Bipolar RF thermotherapy appears to be an effective method for patients with BPO who cannot be operated. Due to the surgical risks of patients dependent on the catheter in spite of receiving medical treatment, it is a good alternative to remove catheter dependence. It may be one of the methods that should be remembered, especially in this patient group.