Transurethral Microwave Therapy (TUMT) for Benign Prostatic Hyperplasia
In transurethral microwave therapy (TUMT), an
instrument (called an antenna) that sends out microwave energy is inserted
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.
To treat an enlarged prostate, some people use herbs, from flaxseed to stinging nettle to prickly pear cactus. At typical doses, experts say that most plant extracts are probably safe for BPH, or benign prostatic hyperplasia. But do they work?
Some supplements may help. Others -- including the most popular, saw palmetto -- might not. And a few, including zinc, may actually put you at risk for getting BPH.
This treatment is done in a single
session. It usually does not require an overnight stay in the hospital. A
spinal anesthetic is needed during the
Microwave therapy is also known as cooled thermal
therapy or by the name of the equipment used.
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 medicines.
generally return to work 1 to 2 days after treatment. Sexual activity can be
resumed 1 to 2 weeks after surgery.
Studies note that TUMT is more
effective than treatment with the alpha-blocker terazosin when checked 18
In a summary of very small
studies, TUMT did not improve symptoms and urine flow as much as transurethral
resection of the prostate (TURP) did. But men seemed equally happy with either
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 to be less common after TUMT
than after TURP.1
include persistent irritation of the urethra and blood in the urine.2
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.
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.
Fitzpatrick JM (2007). Minimally invasive and
endoscopic management of benign prostatic hyperplasia. In AJ Wein, ed.,
Campbell-Walsh Urology, 9th ed., vol. 3. pp. 2803-2844.
Philadelphia: Saunders Elsevier.
Webber R (2006). Benign prostatic hyperplasia, search
date May 2005. Online version of BMJ Clinical Evidence.
Also available online: http://www.clinicalevidence.com.
Primary Medical Reviewer
E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer
Christopher G. Wood, MD, FACS - Urology, Oncology
March 23, 2010
WebMD Medical Reference from Healthwise
March 23, 2010
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