This form of treatment uses microwaves to produce temperatures hotter than 50 degrees and “zap” the tissue in the prostate’s innermost core, thereby creating space around the urethra. These temperatures are hot enough to do some good; they are able to destroy the smooth muscle and glandular cells in BPH tissue. What grows back over the next few months is a different mixture of cells that include collagen.
TUMT works by miniature remote control: A tiny antenna that targets BPH tissue surrounds a catheter that goes through the penis and into the urethra. The microwave generator is situated nearby, in the rectum. (The device is called the Prostatron.) The degree of power is controlled by different software programs that can produce a range of temperatures.
At Temperatures below 60 Degrees C. The technique produces significant improvements in urinary symptom scores and in urinary flow rates, but litde change in pressure-flow urodynamic studies—which suggests that the ultimate improvement in obstruction may not be great. The procedure can be performed under local anesthesia.
At Really Hot Temperatures—from 60 to 75 Degrees (this may be needed in cases of severe obstruction)—the treatment can create gaping cavities where tissue used to be. This can cause irritative symptoms that last until the tissue in the prostatic urethra dies and then is sloughed and reabsorbed by the body, or washed away by urine. (When all the dead tissue is gone, the prostatic urethra should be much less constricted.) The treatment causes inflammation and may require stronger pain-killing medication. Swelling and urinary retention (usually temporary) are also common after the procedure and can be eased with a catheter. Preliminary results are encouraging. However, how long these results will last—and whether or when a repeat procedure will be necessary—is not yet known.
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