Transurethral microwave therapy (TUMT)

In transurethral microwave therapy, an instrument (called an antenna) that sends out microwave energy is inserted through the urethra to a location inside the prostate gland. 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 rectum during the procedure. If the temperature in the rectum increases too much, the treatment is turned off automatically until the temperature decreases.

Microwave therapy is also known as cooled thermal therapy.

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 regional (spinal) anesthetic is needed during the procedure.

This procedure may be an option for men who want more than medications for treatment of their symptoms.

How well it works

The use of TUMT for treatment of prostatitis has not been well-studied. Recent studies suggest 75% of men treated have fewer prostatitis symptoms. However, the same studies suggest the symptoms also improved in half the men given sham treatment.¹

What to think about

The main complication of TUMT is the inability to urinate (urinary retention) for more than a week. 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 less common after TUMT than after transurethral resection of the prostate (TURP).²

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.

This procedure is not recommended for men who have prostate cancer, who are suspected of having prostate cancer, or who have prosthetic hip joints or pacemakers.

Citations

1. Nickel JC (2007). Inflammatory conditions of the male genitourinary tract: Prostatitis and related conditions, orchitis, and epididymitis. In AJ Wein et al., eds., Campbell-Walsh Urology, 9th ed., vol. 1, pp. 304–329. Philadelphia: Saunders Elsevier.

2. Fitzpatrick JM, Mebust WK (2002). Minimally invasive and endoscopic management of benign prostatic hyperplasia. In PC Walsh et al., eds., Campbell's Urology, 8th ed., vol. 2, pp. 1379–1422. Philadelphia: W.B. Saunders.