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Nocturia Reduction after Cooled ThermoTherapy for Symptomatic Benign Prostatic Hyperplasia
Aaron F Brafman1, Stephen J Eyre2, Lori B Lerner3
1Boston University School of Medicine, Boston, MA;2Brigham, Boston, MA;3VA Boston Healthcare System, Boston, MA
Introduction:
Nocturia is a common complaint in benign prostatic hyperplasia (BPH) patients suggesting clinically significant disease. Cooled ThermoTherapyTM (CTT) is a minimally invasive BPH treatment. We explored how much nocturia improved after CTT and whether or not more than BPH could be contributing.
Methods:
Using Urologix maintained data of 796 men from numerous multi-center studies we examined nocturia via American Urological Association Symptom Scores (AUASS), BPH Impact Index (BII), quality of life (QOL), and peak flow (Qmax) at baseline, 6 months, 1, 2, and 4 years post-CTT. Patients were divided into 3 groups by baseline nocturia score: 1) 0-1; 2) 2; 3) >2. One-way analysis of variance, Tukey's multiple comparison test, chi square, Pearson's correlation, and repeated measures regression analyses were performed.
Results:
Groups 1 (N=119), 2 (N=228) and 3 (N=449) were similar in baseline prostate volume, body mass index, prostate specific antigen level, and diabetes and cardiac disease prevalence. Group 3 was older than the other groups and saw the greatest nocturia improvement post-CTT. BII, AUASS, QOL, Qmax and nocturia improvement was seen across groups post-CTT and sustained through 4 years. Nocturia improvement positively correlated to QOL, BII and AUASS across groups. Each point reduction in nocturia improved QOL by 0.5 and BII by 1.0. However, other unidentified factors also affected nocturia.
Conclusions:
CTT leads to sustained improvements in nocturia, BII, AUASS, QOL and Qmax. QOL, BII and AUASS positively and predictably correlate with nocturia. No co-morbid predictors which correlate with the degree or lack of improvement were identified.
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