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Transurethral microwave thermotherapy is a non-surgical, minimally invasive therapy that can be performed under a local anesthetic on an outpatient basis. The treatment involves inserting a special microwave urinary catheter into the hyperplastic prostatic urethra.
The resulting scar tissue later atrophies, reducing the size of the prostate which in turn reduces the constriction of the urethra. It can be done with a local anesthetic on an outpatient basis. [1] It takes about an hour to perform the procedure. [2] It takes about 30 days for the ablated prostate tissue to resorb. [3]
Prostate laser surgery is used to relieve moderate to severe urinary symptoms caused by prostate enlargement. The surgeon inserts a scope through the penis tip into the urethra. A laser passed through the scope delivers energy to shrink or remove excess tissue that is preventing urine flow. [7] Different types of prostate laser surgery include:
Bleeding may be reduced by pre-treatment with an anti-androgen such as finasteride [6] [7] [8] or flutamide. [citation needed] Clot retention and clot colic. The blood released from the resected prostate may become stuck in the urethra and can cause pain and urine retention. Bladder wall injury, such as perforation (rare).
The prostatic urethra, the widest and most dilatable part of the urethra canal, is about 3 cm long.. It runs almost vertically through the prostate from its base to its apex, lying nearer its anterior than its posterior surface; the form of the canal is spindle-shaped, being wider in the middle than at either extremity, and narrowest below, where it joins the membranous portion.
Treatment is typically with a catheter either through the urethra or lower abdomen. [1] [3] Other treatments may include medication to decrease the size of the prostate, urethral dilation, a urethral stent, or surgery. [1] Males are more often affected than females. [1] In males over the age of 40 about 6 per 1,000 are affected a year. [1]
The underlying mechanism involves the prostate pressing on the urethra and thereby making it difficult to pass urine out of the bladder. [1] Diagnosis is typically based on symptoms and examination after ruling out other possible causes. [2] Treatment options include lifestyle changes, medications, a number of procedures, and surgery.
The RCT from 2016 comparing prostate steam treatment to a sham procedure (a placebo) found three months after the operation with moderate certainty that this procedure may improve the quality of life for men with moderate urinary symptoms. [5] [6] Observational studies showed positive outcomes up to four years of follow-up.
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