Transurethral microwave thermotherapy (TUMT) is an outpatient procedure to treat urinary symptoms caused by an enlarged prostate, a condition known as benign prostatic hyperplasia (BPH). TUMT is generally considered a safe procedure with a low risk of side effects. It's generally used for men with other health conditions for whom more invasive surgery isn't recommended.
A small microwave antenna is inserted through the tip of the penis into the tube that carries urine from the bladder (urethra). Your doctor extends the antenna until it reaches the area of the urethra surrounded by the prostate. The antenna emits a dose of microwave energy that heats and destroys the excess prostate tissue that is blocking urine flow.
TUMT is one of several minimally invasive treatment options for BPH. To determine the right treatment for you, your doctor will consider the severity of your symptoms, any other health problems you have, and the size and shape of your prostate.
TUMT helps reduce urinary symptoms caused by BPH, including:
TUMT can offer advantages over other methods of treating BPH, such as transurethral resection of the prostate (TURP) and open prostatectomy. The advantages might include:
TUMT is generally safe with few if any major complications. Possible risks of TUMT might include:
Because of potential complications, TUMT might not be a treatment option if you have or have had:
If you have other conditions that increase your risk of bleeding or if you take blood thinners — such as warfarin (Jantoven) or clopidogrel (Plavix) — your doctor may recommend a different procedure to treat your urinary symptoms.
You may be prescribed an antibiotic to prevent a urinary tract infection.
Arrange transportation home. You won't be able to drive after the procedure that day or generally if you have a catheter in your bladder.
You might not be able to work or do strenuous activity for 3 to 5 days after surgery. Ask your doctor how much recovery time you might need.
You'll be given a local anesthetic to numb the prostate area. The anesthetic might be inserted through the tip of your penis, or given in a shot via your rectum or in the area between your scrotum and anus.
You might also have intravenous (IV) sedation. With IV sedation, you'll be drowsy but remain conscious during the procedure.
Your doctor inserts a catheter with a microwave antenna into your urethra through the tip of your penis. A thermometer inserted into your rectum checks temperature. The antenna and thermometer have balloons attached that hold them in place. Your doctor might check the placement of the catheter and the rectal thermometer using an ultrasound machine.
During the procedure, the microwave antenna causes just enough heat to destroy the prostate tissue blocking your urine flow, but not enough to damage other tissue. Water circulating around the tip and sides of the antenna protects the urethra from heat. But you might feel some heat and discomfort in the prostate and bladder areas.
Your doctor will ask about your pain level and adjust your treatment to make sure you're getting enough heat to improve your symptoms. You'll need to stay as still as possible during the microwave treatment. The length of treatment time varies depending on your doctor's preference and the type of microwave therapy machine used.
During treatment, you might have a strong desire to urinate and may feel bladder spasms — sensations that usually go away after the treatment is finished.
Most men can go home the same day after the procedure, and recover in just a few days. You'll likely have a urinary catheter in place because of swelling that blocks urine flow. You may need to take antibiotics to prevent a urinary tract infection.
You might notice:
It might take several weeks to months for you to experience noticeable improvement in urinary symptoms. Your body needs time to break down and absorb overgrown prostate tissue that's been destroyed by microwave energy.
After TUMT, it's important to have a digital rectal exam once a year to check your prostate and screen for prostate cancer, as you would normally. If you notice any worsening urinary symptoms, see your doctor. Some men need re-treatment.