Transurethral Microwave Therapy for Benign Prostatic Hyperplasia

Benign prostatic hyperplasia (BPH) is an enlargement of the prostate that occurs in nearly one-hundred percent of men as they age. Some primary problematic symptoms reported by men experiencing BPH include difficulty urinating or a need to get up many times during the night to urinate, a frequent urge to urinate, or a sense that the bladder is not completely empty after urination. The need for treatment is largely dictated by how bothersome the symptoms become and usually can be treated with prescription medication. While BPH is a non-cancerous condition, these symptoms should be evaluated by an urologist to ascertain that they are not actually caused by prostate cancer.

In order to treat some of these bothersome symptoms, a procedure known as transurethral microwave therapy (TUMT) is performed. TUMT uses an instrument called an antenna that is inserted through the urethra to the prostate. This antenna emits microwave energy that heats up the prostate gland itself. To prevent the temperature from getting too high, a sensor is inserted into the rectum during the procedure. When the rectal temperature rises to a pre-determined point, the treatment is automatically suspended until the temperature goes back down. During the treatment, the temperature becomes high enough to kill some of the tissue and as the prostate begins to heal, it shrinks and reduces the blockage of urine flow.

This type of treatment is done in a single session and usually does not require an overnight hospital stay. Sometimes, patients are unable to urinate and may require a catheter to facilitate bladder drainage accompanied by a course in antibiotics or anti-inflammatory medication. Patients usually return to work a day or two after treatment and sexual activity can be resumed after a couple of weeks.

As with any other surgical procedure, TUMT does have certain risk factors. The primary complication of TUMT is urinary retention for more than a week. This condition, punctuated by an inability to consistently urinate is treated by inserting a tube directly into the bladder through the abdominal wall to drain the stored urine. Sexual dysfunction, including problems with erection and retrograde ejaculation which is described as ejaculation backward into the bladder, appear to be less common after a TUMT procedure than with other types of surgeries. Some other commonly reported complications include persistent irritation of the urethra and blood in the urine.

Some medical research reports concerning a TUMT have warned that the procedure has shown in a small number of cases caused serious injuries, including damage to the penis and urethra. A miniscule number of these injuries have actually required colostomies and partial amputation of the penis. In December 2000, the U.S. Food and Drug Administration (FDA) issued a warning about these injuries.

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.
It is important to note that a TUMT procedure is not recommended for men who have active prostate cancer or for men who are suspected of having prostate cancer. However, it has been proven effective for men that suffer from symptoms associate with BPH.