For an understanding on how BPH affects so many men, please review the
BPH page of this site.
For those patients that would like to be treated
without medications, would like to get off medications, and do not want
to go to the hospital to have anesthesia for a laser prostatectomy or
are too sick to do so, microwave thermotherapy of the prostate is another
excellent alternative. This
is an in-office procedure that generally takes about 45 minutes to
perform and is done with a local anesthetic and some very mild sedation
with little to no discomfort.
Microwave therapy results in sustained improvement
in urinary symptoms that last for 5 years or more (the newer systems
that work well have not been around much longer than that). The improvement is not quite as
dramatic as with a TURP or laser prostatectomy (see BPH page), but is better
than with medications alone. The fact that it is a minimally invasive
procedure that works better than medications is what attracts many men
to this therapy. While results are generally good, 30 to 40 percent
of men will have no improvement with this therapy. Laser prostatectomy,
while a little more invasive, improves symptoms in over 90 percent
What tests need to be done prior to considering microwave therapy?
A complete evaluation by a urologist is, of course,
includes a complete history and physical, labaratory tests to ensure there
is no uncontrolled diabetes or other medical problem that may be causing
urinary symptoms, as well as a urinalysis to rule out a urinary tract infection. A
PSA (prostate specific antigen, a blood test screening for prostate
cancer) will be done to rule-out prostate cancer as a cause of symptoms.
If these tests are all normal, then a transrectal
ultrasound is done to get an accurate measure of prostate size. Cystoscopy
(look at the prostate and bladder with a small, flexible scope that is
passed through the penis) is also performed to measure the length of
the prostate so that the appropriate sized catheter can be used.
How is the procedure performed?
Prior to the procedure, we generally have you
take some medications at home, including a pill to prevent bladder spasms,
an antibiotic, and a mild sedative. Somebody needs to drive you
to and from the office to have the procedure.
Another transrectal ultrasound is done so that
a local anesthetic can be injected into the prostate. This involves little to no discomfort. A
small rectal balloon temperature monitor is then placed. A small treatment
catheter is then placed through the tip of the penis into the urethra
and positioned with a balloon in the bladder, which is confirmed by a pelvic
The treatment is then undertaken and takes between
30 and 45 minutes. You
will be watched closely during the procedure to ensure you are comfortable. There
may be a feeling of needing to urinate, some pelvic pressure, and sometimes
the heat can be felt. The vast majority of patients do well with minimal
Once the procedure is finished, the treatment
catheter is removed and a temporary catheter is placed. You will go home with this catheter. The
catheter is then removed a few days later. Once the catheter is out,
it generally takes 2 to 3 months for symptoms to improve. The microwave
energy causes the prostate tissue to slowly die and eventually disappear,
but this takes time.
Dr. Hendricks uses the most up-to-date microwave
systems available. These
systems work well for appropiately selected patients.
Contact us at (707)224-7944 if you would like more information or would
like to arrange a consultation to discuss these treatment options.
Copyright 2006 Napa
Valley Urology Associates