Transurethral Microwave Heating of the Prostate—Or from Hyperthermia to Thermotherapy

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Abstract
The authors studied microwave delivery by a flexible applicator providing simultaneous cooling for anesthesiafree outpatient single session treatment of benign prostatic hyperplasia (BPH) following preclinical trials in dogs and humans. The goal of transurethral microwave thermotherapy (TUMT) was to raise the temperature within the prostate to more than 45°C while maintaining the urethral temperature below 45°C. Histologically, the urethral mucosa and periurethral tissues were well preserved. There was a sharp transition (1-2 mm) to the microwave-treated area, where the normal cellular arrangement disappeared and small blood vessels were thrombosed. Smooth-muscle cells were seen to be more heat sensitive than glandular tissue. In 37 patients with BPH, the new device (Prostatron) produced significant improvements in the symptom score peak/low and post residual volume at 3 months. Seven patients required an indwelling catheter for 1 week after treatment, but four then voided satisfactorily. No infections occurred. Continued followup suggests enduring benefit.