Bdesha 1994.

Study characteristics
Methods	Study design: prospective, randomized parallel study Study dates: study dates not available Setting: outpatient, single‐center, national Country: United Kingdom
Participants	Inclusion criteria: men with: Symptoms of prostatism for at least 6 months World Health Organization's symptom score > 14 Residual urine volume of at least 50 mL Peak flow rate < 15 mL/s Exclusion criteria: men with: Malignant glands Impaired renal function History of prostatic surgery Residual urine volumes > 200 mL Large glands (length from bladder neck to proximal veru > 40 mm) Large obstructing middle lobes Acute urinary retention Coexisting urinary tract disease Total number of participants randomized: 40 Group 1: n = 22 microwave treatment World Health Organization's symptom score, mean (95% CI): 30 (25.2 – 34.8) AUA symptom score, mean (95% CI): 19.2 (16.3 ‐ 22.1) Age, mean: 63.7 years (no 95% CI or SD available) Qmax, mean (95% CI): 12.3 mL/s (10.7 – 13.9) Residual vol, mean (95%CI): 104 mL (85 ‐ 125) Group 2: n = 18 sham treatment World Health Organization's symptom score, mean (95% CI): 31 (25.5 – 36.5) AUA symptom score, mean (95% CI): 18.8 (16.0 ‐ 21.7) Age, mean: 62.6 years (no 95% CI or SD available) Qmax, mean (95% CI): 10.8 mL/s (9.2 – 12.4) Residual vol, mean (95% CI): 80 mL (57 ‐ 103)
Interventions	Group 1 (n = 22):TUMT LEO Microthermer was used in all participants in a single active 90‐min treatment. This machine delivers a maximum power output of 20 watts at 915 MHz. and incorporates an automatic power cut‐off, which operates if the rectal temperature increases to > 42.5 ºC Group 2 (n = 18) Sham: Same procedure, participants received 90‐min sham treatment with no power delivered. Participants received a heating pad to simulate hyperthermia Co‐interventions: topical lidocaine gel was used alongside flexible cystoscopy to exclude a coexisting lower urinary tract pathological condition and to measure the prostate
Outcomes	Urologic symptom scores How measured: AUA symptom score and WHO symptom score. Also as the proportion of participants with a decrease of 50% or more in symptom scores. Time points measured: baseline and 3 months Time points reported: baseline and 3 months Subgroups: none Minor and major adverse events / erectile function / ejaculatory function How measured: Narratively (including sexual adverse events) Time points measured: not reported Time points reported: not reported Subgroups: none Acute urinary retention How measured: narratively Time points measured: not reported Time points reported: not reported Subgroups: none Retreatment How measured: narratively (TURP after sham) Time points measured: not reported Time points reported: not reported Subgroups: none Relevant outcomes not reported in this study Quality of life Indwelling urinary catheter
Funding sources	Not available
Declarations of interest	Not available
Notes	Study unblinded with cross‐over at 3 months and follow‐up to 1 year. 16 participants in the sham group were offered active treatment at 3 months (this was not considered retreatment). No contact information available.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	No information available. Insufficient information to permit judgment of ‘Low risk’ or ‘High risk’.
Allocation concealment (selection bias)	Unclear risk	The study describes only "sealed envelope." Insufficient information to permit judgment of ‘Low risk’ or ‘High risk’.
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Double‐blind study. Participants and study personnel were blinded.
Blinding of outcome assessment (detection bias) Objective outcomes	Low risk	Double‐blind study. Participants and study personnel were blinded.
Blinding of outcome assessment (detection bias) Subjective outcomes	Low risk	Double‐blind study. Participants and study personnel were blinded.
Incomplete outcome data (attrition bias) All outcomes	Low risk	Only 2 participants (10%) in the sham group were lost at follow‐up.
Selective reporting (reporting bias)	Unclear risk	No protocol available. Insufficient information to permit judgment of ‘Low risk’ or ‘High risk’.
Other bias	Low risk	No other sources of bias were identified.