Transurethral microwave therapy (TUMT) for benign prostatic hyperplasia
Surgery Overview
In transurethral microwave therapy (TUMT), an instrument (called an antenna) that sends out microwave energy is inserted through the urethra to a location inside the prostate. Microwave energy is then used to heat the inside of the prostate. Cooling fluid is circulated around the microwave antenna to prevent heat from damaging the wall of the urethra. To prevent the temperature from getting too high outside the prostate, a temperature sensor is inserted into the man's rectum during the procedure. If the temperature in the rectum increases too much, the treatment is turned off automatically until the temperature goes back down.
The temperature becomes high enough inside the prostate to kill some of the tissue. As this part of the prostate heals, it shrinks, reducing the blockage of urine flow.
This treatment is done in a single session. It usually does not require an overnight stay in the hospital. A general or spinal anesthetic is needed during the procedure.
Microwave therapy is also known as cooled thermal therapy or by the name of the equipment (Targis or Prostatron).
What To Expect After Surgery
You are generally able to go home after surgery. You may not be able to urinate and may require catheterization to drain your bladder. For most men, this lasts for a week or less. You may also have to take antibiotics or anti-inflammatory medications.
You can generally return to work 1 to 2 days after treatment. Sexual activity can be resumed 1 to 2 weeks after surgery.
Why It Is Done
TUMT is done to help relieve the symptoms of benign prostatic hyperplasia (BPH). It is an option for men who want more than medications for treatment of their symptoms.
How Well It Works
Studies note that TUMT is more effective than treatment with the alpha-blocker terazosin when checked 18 months later.1
In one study, transurethral resection of the prostate (TURP) improved symptoms better than TUMT. But in two other studies, there was no major difference in how well the two treatments worked.1
Risks
The main complication of TUMT is the inability to urinate (urinary retention) for more than a week.2 This condition is treated by inserting a tube directly through the abdominal wall into the bladder to drain urine (suprapubic catheter). Erection problems and retrograde ejaculation (ejaculation backward into the bladder) appear to be less common after TUMT than after TURP.2
Other complications include persistent irritation of the urethra and blood in the urine.1
Recent reports have warned that the procedure has in a small number of cases caused serious injuries and complications, including damage to the penis and urethra. Injuries have required colostomies, partial amputation of the penis, and other procedures. In December 2000, the U.S. Food and Drug Administration (FDA) issued a warning about these injuries.3
What To Think About
Most trials using TUMT have been limited by a small number of participants, a short length of time of study, and limited follow-up of the participants after the trial ended.1
This procedure is not recommended for men with prostate cancer, men who are suspected of having prostate cancer, or men with prosthetic hip joints or pacemakers.
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| Author: | Monica Rhodes | Last Updated: March 31, 2006 |
| Medical Review: | E. Gregory Thompson, MD - Internal Medicine Christopher G. Wood, MD, FACS - Urology/Oncology | |
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| Topic Contents | |
| Surgery Overview | |
| What To Expect After Surgery | |
| Why It Is Done | |
| How Well It Works | |
| Risks | |
| What To Think About | |
| References | |