Trans-Urethral Microwave Therapy (TUMT) of the Prostate

Overview

TUMT is Trans-Urethral Microwave Therapy, which is done to help relieve the symptoms of an enlarged prostate or Benign Prostatic Hyperplasia (BPH).  TUMT is an option for men who want more than medications for treatment of their symptoms.

What is Microwave Therapy?

The Prolieve system of thermodilatation therapy is the latest generation in microwave therapy for treating BPH.  In addition to the utilization of heat to reduce the prostate tissue from impeding flow, it also utilizes pressure to compress this tissue, which will also reduce the narrowing caused by the excessive prostate tissue.  Earlier microwave therapies were effective, but some were not well tolerated by patients and serious side effects occurred.

Boston Scientific with its Prolieve system has found an optimal dose and system design that offers excellent tolerance, minimal side effects, and significant symptom improvement.

What happens during the procedure?

Local anesthetic will be introduced and then a flexible catheter will be passed through the urethra by your Urologist.  The catheter contains a microwave coil that delivers heat to the prostate.  It also contains a pressure balloon that will be inflated following insertion of the catheter to apply pressure to the prostatic urethra and dilate the urethral opening.  This catheter will be connected to a computer operated system that will control both the microwave wattage and pressure generated during your treatment.  A probe will also be placed rectally, to monitor your body temperature.  The actual treatment time is 45 minutes.  You will be given or provided with prescriptions for mild pain prior to your procedure.

 

TUMT

What happens after the treatment?               

At the end of the procedure, if you are able to urinate or void and your urologist determines it is appropriate, you will be sent home without a catheter.  If you are unable to void, a small catheter will be placed to drain urine from your bladder for a few days.  During this time, you will need to take it easy.  Once your physician determines that the catheter may be removed, you will be free to resume your normal day-to-day activities.

Pre-Operative Instructions Diet

1.  Limit your intake of fluids on the day of the procedure.

2.  Be sure to eat something on the day of your procedure.

Medications

  1. You may take all your daily medications unless otherwise indicated by your physician.
  2. Aspirin products should be discontinued as directed by Doctor.  If blood thinners are taken, discontinue this medication for a few days prior to your procedure.
  3. You will be given several prescriptions for use prior to and following your    procedure:
  4.      a.   If Levaquin 500 mg., take 1 tablet the day before your procedure and 1 tablet daily thereafter, until gone.
  5.      b.   If Cipro 500 mg., or Bactrim DS, take 1 tablet the night before your procedure, 1 tablet the morning of your procedure, and the remaining tablets will be taken one tablet twice a day until gone.
  6. Motrin 2 tablets, 2-3 times daily.  This is an anti-inflammatory medication.  Begin this medication the day of your procedure. You will then continue to take two tablets 2-3 times daily for one week following your procedure.
  7. Vicodin 2 Tablets.
  8. Take two tablets prior to coming in for your procedure.
  9. Take one tablet prior to coming, and bring the second tablet with you.
  10.  Ativan 2 mg.  This will be provided to you prior to your procedure.
  11.  Ditropan XL, 1 tablet.  This will be provided to you prior to your procedure.

Special Instructions

  1. You must make arrangements for transportation to and from the procedure. You may not drive yourself
  2. Wear loose fitting clothing to your procedure. Be sure to wear brief-style underwear.
  3. A catheter may be placed in your bladder for approximately 3-7 days. If placed, you will be given an appointment for its removal. Do not attempt to remove it yourself.
  4. Reduce the amount of alcoholic or caffeinated  beverages, and tobacco products 48 hours prior to your procedure.
  5. A Fleets enema should be taken 2 hours prior to the procedure.

Post-Operative Instructions

Diet

You may resume a normal balanced diet following the procedure. Increase your water intake to re-establish and maintain proper hydration, and flush the urinary tract.

Activity

Please try to take it easy for a few days. If a catheter is placed, you should refrain from any strenuous activity until the catheter is removed.

Catheter Care

If a catheter is placed, your bladder will be drained through this small flexible tube for the next few days.  The catheter has been placed through your urethra to your bladder. You do not have to do anything to urinate; the catheter will automatically drain urine from your bladder into the drainage bag. If you do not see any urine draining into the bag, and you are uncomfortable, call your physician’s office. Leakage around the catheter is normal.

You may want to put some tissue or padding in your undergarments to capture this drainage. You will need to change this tissue periodically.

Follow Up Appointment

You will be provided with a follow up appointment for the removal of your catheter and to check on your post-operative condition.  Drink plenty of water the day of your follow up visit!

Medications

You have been given a prescription for an anti-inflammatory and an antibiotic. Please take them as directed. If a catheter is placed, additional medication may be given.  Specific instructions for use of this medication will be given when dispensed.  Significant pain following this procedure is unusual, so pain medication will not be routinely prescribed.  If you do develop significant pain, please contact our office

Post-Surgical Expectations

After your procedure, you can expect some or all of the following conditions:

  • Current symptoms should improve gradually over the next 6-8 weeks.
  • Minor discomfort (soreness) in your abdomen or sitting may be uncomfortable.
  • Bloody discharge from your penis.

Contact Physician Immediately if:

  • You have pain, more severe than can be controlled by over-the-counter analgesic medication or prescribed pain medications.
  • You have fever of greater than 101ºF
  • You experience chills or shaking.
  • There is evidence that the catheter is not draining urine, or there is constant leakage around the catheter.
  • Excessive bleeding occurs.
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