53850 Transurethral destruction of prostate tissue; by microwave thermotherapy

Name of the Procedure:

Transurethral Destruction of Prostate Tissue by Microwave Thermotherapy (TUMT)

Summary

Transurethral Microwave Thermotherapy (TUMT) is a minimally invasive procedure used to treat benign prostatic hyperplasia (BPH), a condition characterized by the enlargement of the prostate gland. The procedure utilizes microwave energy to generate heat, which destroys excess prostate tissue, reducing the size of the prostate and alleviating symptoms.

Purpose

The primary purpose of TUMT is to relieve symptoms caused by BPH, such as difficulty urinating, frequent urination, and weak urine stream. By shrinking the prostate, the procedure aims to improve urinary flow and reduce discomfort associated with an enlarged prostate.

Indications

• Symptoms of urinary retention
• Frequent urination, especially at night
• Weak or intermittent urine stream
• Sensation of incomplete bladder emptying
• Patients who have not responded well to medication for BPH or those who prefer a minimally invasive option over traditional surgery

Preparation

• Patients may be advised to stop taking certain medications (e.g., blood thinners) several days before the procedure.
• Fasting may be required for a few hours prior to the procedure.
• Pre-procedure diagnostic tests, such as blood tests, urine tests, and imaging studies (e.g., ultrasound), may be conducted to assess the prostate.

Procedure Description

1. The patient is positioned and local anesthesia is administered to numb the urethra and prostate area.
2. A catheter with a microwave antenna is inserted into the urethra and advanced to the location of the prostate.
3. Microwave energy is emitted from the antenna, generating heat that selectively destroys prostate tissue.
4. Cooling mechanisms within the catheter help protect the urethra from heat damage.
5. The procedure duration is monitored, and the microwave energy is adjusted as necessary to achieve the desired tissue destruction.
6. Once the treatment is completed, the catheter is removed.

Duration

The procedure typically takes about 30 minutes to 1 hour to complete.

Setting

TUMT is usually performed in an outpatient clinic or hospital setting.

Personnel

• Urologist
• Nursing staff
• Technicians for operating and monitoring the microwave equipment

Risks and Complications

• Temporary urinary retention post-procedure requiring a catheter
• Urinary tract infection (UTI)
• Mild to moderate pain or discomfort during and after the procedure
• Blood in the urine (hematuria)
• Rarely, urinary incontinence or erectile dysfunction

Benefits

• Reduction in BPH symptoms, leading to improved urinary flow
• Minimally invasive with a shorter recovery time compared to traditional surgery
• Reduced need for long-term medication
• Symptom relief can often be observed within a few weeks post-procedure

Recovery

• Patients may experience some discomfort or mild pain, which can be managed with pain relief medications.
• Avoid strenuous activities and follow the urologist's instructions regarding catheter care if one was inserted.
• Regular follow-up appointments to monitor progress and manage any complications.
• Most patients can return to normal activities within a few days to a week.

Alternatives

• Medications (e.g., alpha-blockers, 5-alpha-reductase inhibitors)
• Other minimally invasive procedures (e.g., transurethral needle ablation, laser therapy)
• Surgical options (e.g., transurethral resection of the prostate (TURP), open prostatectomy)
• Pros and cons of alternatives: Medications may have fewer immediate risks but may require long-term use; surgical options generally offer more definitive relief but come with higher risks and longer recovery times.

Patient Experience

Patients may feel mild to moderate discomfort during the procedure, which is usually well-managed with local anesthesia. Post-procedure, patients might experience temporary urinary symptoms, such as frequency and urgency, which typically resolve within a few weeks. Pain management is provided as needed, and patients are encouraged to stay hydrated and follow post-procedure care instructions to aid in recovery.