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Transrectal Microwave Thermotherapy


Why is this procedure done?


The prostate is a gland at the base of the bladder in men. Sometimes, it may become too large. Then, less urine flows out of the bladder opening. The bladder may not empty fully. When you have a large prostate, it is called benign prostatic hypertrophy or BPH. Doctors may do a procedure to help with this problem. They will use a small tool to apply microwave energy to the prostate. This is called transrectal microwave thermotherapy or TRMT. ‚  
This procedure may be done if you are having problems with: ‚  
  • Passing urine often
  • Getting up at night to pass urine
  • Urgency
  • Slow or weak stream
  • Pain while passing urine
  • Leaking urine
  • Not able to empty your bladder


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What will the results be?


You will be able to pass urine more easily. You will have fewer signs. ‚  

What happens before the procedure?


  • Your doctor will take your history. Talk to the doctor about:
    • All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
    • Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin, ibuprofen, Aleve (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
    • When you need to stop eating or drinking before your procedure.
  • Your doctor will do an exam and may order:
    • Digital rectal exam ¢ ˆ ’ You would be asked to bend over a table or to lie on your side holding your knees close to your chest. The doctor would put a finger into your rectum to feel the prostate.
    • PSA blood test
    • Urine test
    • Ultrasound
    • CT scan
  • Your doctor will give you drugs to clean your bowels. Take them the night before the procedure.
  • You will not be allowed to drive right away after the procedure. Ask a family member or a friend to drive you home.

What happens during the procedure?


  • You will have an IV put into your arm and you will receive drugs to sedate you. You will feel sleepy but awake.
  • In the procedure room, you will be given a drug to numb the prostate area. This is given as an injection in or near your rectum. It will help you stay pain free. You may feel some discomfort during the procedure. You may feel a strong urge to pass urine. Tell your doctor right away if the pain becomes very bad.
  • The doctor will put a small microwave tool into your rectum. The doctor will put a thermometer inside the rectum to carefully watch the temperature.
  • The microwave energy is applied with the tool to the extra tissue that is blocking the flow of urine.
  • The doctor will remove the tool and thermometer when done.
  • This procedure may take 45 to 60 minutes.

What happens after the procedure?


  • You will go to the Recovery Room and the staff will watch you closely.
  • You will have a small tube called a catheter in your bladder. This will help drain urine. Your urine may have blood and small clots in it.

What care is needed at home?


  • Ask your doctor what you need to do when you go home. Make sure you ask questions if you do not understand what the doctor says. This way you will know what you need to do.
  • You need to limit your activity and rest after the procedure for 1 to 2 days. Your doctor will tell you when you can return to your normal activity level.
  • You need to drink 6 to 8 glasses of water each day. This is very important if your urine becomes red. It means your treated area is bleeding.
  • You will need to care for your catheter:
    • Keep your catheter bag lower than your bladder at all times
    • Empty your catheter bag when it is half full
    • Take extra care when moving around. Tape the catheter on your skin to avoid pulling on it.
    • You need to keep your penis clean to prevent infection. Wash it with soap and water at least two times each day.
  • Avoid constipation or straining during bowel movements. Ask your doctor if you should use a laxative.

What follow-up care is needed?


  • Your doctor may ask you to make visits to the office to check on your progress. Be sure to keep these visits.
  • The urine catheter will be removed. Do not try to take it out by yourself.
  • Your doctor will tell you if you need to see a urologist.

What problems could happen?


  • Infection
  • Bleeding
  • Very bad pain or bladder spasms
  • Trouble passing urine
  • Sex problems like problems with erection, lower desire for sex, and problems with ejaculation

Where can I learn more?


American Urological Association Foundation ‚  
http://www.urologyhealth.org/urology/index.cfm?article=4 ‚  
National Kidney and Urologic Diseases Information Clearinghouse ‚  
http://kidney.niddk.nih.gov/kudiseases/pubs/prostateenlargement/ ‚  

Consumer Information Use and Disclaimer


This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚  

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