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 used.

what to expect

you are typically able to go home after surgery. you may not be able to urinate and may need catheterization to drain your bladder. for most men, this lasts for a week or less.

you can typically 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 medicines for treatment of their symptoms.

how well it works

one study showed that tumt improved symptoms and urine flow better than the alpha-blocker terazosin when checked 6 months and 18 months later.^{footnote 1}

studies find that tumt does not improve symptoms and urine flow as much as turp does.^{footnote 1}

risks

the main complications of tumt include:^{footnote 1}

• 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.
• 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.