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TUMT takes less than an hour. It's usually done as an outpatient procedure, which means you'll go home the day of surgery. A local anesthetic helps to control pain during the procedure, and you'll probably have intravenous (IV) sedation. With IV sedation, you'll be drowsy but conscious.
During the procedure
To start the procedure, your doctor will insert a catheter with a microwave antenna into your urethra. A thermometer is inserted into your rectum to monitor temperature. Both will have balloons attached that hold them in place. Your doctor may check the placement of the catheter and the rectal thermometer using an ultrasound machine.
During microwave treatment, water circulates around the tip and sides of the antenna to protect the urethra from heat. Your doctor will give you enough pain medication to so that it won't hurt too much — but you'll still feel some heat and pain in the prostate and bladder areas. Your doctor will tell you how much pain to expect during the procedure and may show you how to use an emergency stop button if pain gets too bad.
Feeling a little pain during the procedure is important because your doctor will ask you about your pain level and adjust your treatment to make sure you're getting enough heat to improve your symptoms — but not so much that it causes unnecessary damage to your prostate or surrounding areas. You'll need to stay as still as possible during the actual microwave treatment, which lasts a few minutes.
During treatment, you may have a strong desire to urinate and may feel bladder spasms — sensations that usually go away after the treatment is finished.
After the procedure
After the procedure, follow your doctor's instructions for recovery.
- Don't take blood thinning medications until your doctor says it's okay.
- Don't do any strenuous activity, such as heavy lifting, for three to five days.
- Don't have sex until your doctor says it's okay. For most men, this is a week or two after the procedure.
- Don't drive for the rest of the day after your procedure.
For a few days or even weeks, it's normal to have urgent, frequent urination and small amounts of blood in your urine (hematuria). Painful urination can persist for several weeks after TUMT.
You will need to have a tube inside your penis to allow urine to pass from your bladder (urinary catheter) for a few days after the procedure. If you're unable to urinate after that, your doctor may give you a catheter you can insert on your own a few times a day until you are able to urinate.
- Fitzpatrick JM, et al. Minimally invasive and endoscopic management of benign prostatic hyperplasia. In: Wein AJ, et al. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/125743340-3/0/1445/91.html?tocnode=54305416&fromURL=91.html. Accessed March 12, 2009.
- AUA guideline on the management of benign prostatic hyperplasia: Diagnosis and treatment recommendations. Baltimore, Md.: American Urological Association. http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines/main-reports/bph-management/chapt_1_appendix.pdf. Accessed March 12, 2009.
- d'Ancona FC. Nonablative minimally invasive thermal therapies in the treatment of symptomatic benign prostatic hyperplasia. Current Opinion in Urology. 2008;18:21.
- Gravas S et al. Transurethral microwave thermotherapy: From evidence-based medicine to clinical practice. Current Opinion in Urology. 2007;17:12.
- Hoffman RM et al. Microwave thermotherapy for benign prostatic hyperplasia. Cochrane Database of Systematic Reviews. 2007:CD004135.
- Cunningham GR, et al. Surgical and other invasive therapies of benign prostatic hyperplasia. http://www.uptodate.com/home/index.html. Accessed March 12, 2009.
