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.
The Benign Prostate Hyperplasia (BPH) Symptom Score Index can help your doctor understand how severe enlarged prostate symptoms are.
If your total score is less than seven, your symptoms are considered mild. Higher scores indicate more severe symptoms. Your doctor can discuss your scores with you -- and what they indicate about your need for treatment.
Use the following point scale to answer each of the questions. Total the score from all the questions.
0 = Not at all
3 = About...
A complete inability to urinate (urinary retention). You may need to have a tube inserted directly through the abdominal
wall into the bladder to drain urine (suprapubic catheter).
A strong urge to urinate (overactive bladder), which can also cause leaking of urine (urge incontinence).
Irritation of the urethra and blood in the urine (though not as much as with TURP).
Men who have TUMT don't lose as much blood as men who have TURP. So men who have TUMT have less need for a blood transfusion. They also have less of a problem with retrograde ejaculation than men who have TURP.
Reports have warned that in a
small number of cases the procedure has caused serious injuries and complications, including
damage to the penis and urethra. Injuries have required
urostomies, 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 with the participants after the trial ended.