...Collected from the prostatitis newsgroup...
Be careful with that prostatron, you might lose your penis!
Editor's note: In mid-1996, FDA approved a device called the "Prostatron" for use in treating prostate disorders. Some doctors are recommending the device, which heats the prostate gland by means of a microwave device inserted up the urethra, for treatment of prostatitis. Collected here are a number of comments, many of them made anonymous at the commenter's request, which appeared in the newsgroup. After we posted some of them in this spot, the manufacturer of the Prostatron
wrote to us and pointed out that there are TWO devices under discussion, and how to distinguish between them. All of these comments , including the comments from the prostatron manufacturer, reflect the views of the individuals involved, not those of The Prostatitis Foundation or the webmaster and are presented here for your reference only. Jump to a strongly positive patient comment from Fall, 1998.
Dear Mr Smith:
I am with EDAP Technomed the company that manufactures the Prostatron device. I visited your site recently because I wanted to include a link on our web page to the Prostatitis page as an on-line resource for patients. I noticed you have a entire section on Prostatron. I also noticed you've included Urologix information, one of our competitors under this category. Prostatron is a registered Trademark of EDAP Technomed and therefore, we do not believe it is appropriate to include competitors information/comments under "Prostatron". I understand the Prostatitis Foundation does not want to be involved in the differences between the competitor's TUMT devices. Perhaps the best solution would be to list comments on both devices under a common, more generic, category such as Thermotherapy. (TUMT is also a registered trademark of ET)
I appreciate the service your Foundation is providing to patients confused about all the different BPH therapies flooding the medical market.
received FDA approval for 2.5, a higher-energy treatment, indicated for patients
with more severe or obstructive BPH in Dec 1997. For more information, you are
welcome to visit our website at http://edaptechnomed.com
EDAP Technomed, Inc.
179 Sidney Street
Cambridge, MA 02139
Webmaster's note: previously, EDAP had provided in this space a comparison table between its product and that of a competing firm. This information has been deleted, since the competitor felt the information about the competitor's product was incorrect. We don't want to get overly involved in different firms' products. For information on EDAP write them or visit their website at http://www.edaptechnomed.com
or E-mail Liz De Nolfo at firstname.lastname@example.org
November 1, 1996
From: Dave Mason
Subject: Re: microwaving prostate
I had the TUMT in Canada in 1993. It was done at the International Prostate Centre in Windsor Ontario. The Doctors involved were Dr. Sorenson at the Centre and Dr. Nickel
at Queens University
in Kingston, Ontario. It was part of a study/experiment. Dr. Nickel claims that many men in the study were helped. Personally, I am worse...urinary and perineum burning. The procedure itself is uncomfortable but not painful. Apparently about 20% of the men go into retention (can't pee). I was one of the unfortunate ones. It fried me so good that the swelling kept me on a cathater (sp?) and leg bag for a month.
Personally, I wouldn't recommend it.
Subject: Prostatron From: Stanley Ruger
Date: Wed, 28 Aug 1996 20:04:26 -0400
This proceduree has been approved by FDA since 5/96. Would like any comments from people who have had this procedure. Comments on the procedure, side effects, long term effects,...and did it do any good. Any info appreciated.
Subject: Re: Prostatron
From: Ken Smith
Date: Thu, 29 Aug 1996 12:53:35 -0500
Quoting my post from May 6, 1996:
In a Monday, May 6 article by reporter William Wineke in the (Madison) Wisconsin State Journal, Dr. Michael Kuglitsch, a Physicians Plus Medical Group urologist discussed the economics of the Commander Cody BPH cure, the "Prostatron."
Quoting the article:
"They've been trying to sell that machine to every urologist in the country," Kuglitsch said. "It sells for about $260,000 and it will cost between $4000 and $6000 a procedure to make it pay for itself."
The article intimated that a TURP would cost on the order of $10,000, while drugs like proscar and hytrin might cost as little as $300 a year. Even the $260,000 Prostatron only has been shown to help for an average of four years, the article said.
Quoting the article again:
One side effect is that about one-third of men who have the procedure experience a swelling that makes them temporarily unable to urinate. "This is a major inconvenience," Kuglitsch noted. "You leave the office with a catheter in place."
i recently participated in an FDA study wherein i was treated with microwave (heat) applied to the prostate thru an urethra catheter. this was not the prostatron that i believe has been approved. the equipment was supplied by a company called Urologix or Urologics i can't remember which. anyway, since i had the treatment, four months ago, i have had sexual problem. the worst problem is a pain in my penis during sex. the pain is sharp and seems to be inside the urethra about midway or maybe closer to the end and i feel the pain when pressure is applied to the end.
the uro in charge of the study doesn't seem interested in my problem and just says hmmm and downplays my symtoms, making my feel rather stupid for bringing it up.
Subject: Prostatron Advice
From: Anonymous Date: Sun, 14 Jul 1996 15:11:18 -0400
I attempted a long post on this subject which was, i think, devoured by AOL which responded to my send command with "GOODBYE"
I am a 44 year old TN trial lawyer beddeviled by a year of what is usually diagnosed as prostratitis. Antibiotics which worked in the past had no effect this time with Hytrin and Elevil providing some but minimal relief. "Arginol" bladder irrigation was a great joy (just kidding- 9 catherizations) with temporary improvement but ultimate worsening of symptoms which now consist of a frequent need to urinate often with dribbling results and an incessant and unmerciful pain in my lower back which used to ache but now BURNS!
Research reported on this newsgroup and elsewhere has evidenced success on chronic prostatitis through Transurethral Microwave Thermography-TUMT which is now FDA approved for BPH. Only post I have seen related to a gentleman`s side effects from participation in research.Any other experience?
I am responsible to a large staff 200+ clients and 5 children and am becoming increasingly desperate. Thoghts, comments and ideas will be sincerely appreciated.
Subject: Re: Prostatron Advice
From: Ken Smith
Date: Sun, 14 Jul 1996 19:50:37 -0500
In article (Anonymous) wrote:
"Research reported on this newsgroup and elsewhere has evidenced success on chronic prostatitis through Transurethral Microwave Thermography-TUMT which is now FDA approved for BPH."
I don't believe any of the regular active members of this newsgroup would want you to submit to any so drastic and irreversible a procedure as microwave cooking of the prostate for prostatitis. You should view our website at http://www.prostatitis.org and read deeply there. I'm going to spell out a personal summary of what I know about this in the starkest terms, it's all personal opinion, I'm not a doctor, and you should form your own opinion.
Most doctors including many "reputable" urologists don't seem to know much about diagnosing and treating prostatitis. Prostatitis is almost always caused by an infectious organisms. Most doctors are very poor at detecting them because the infection lives trapped in tiny sacks within the prostate gland called "acini" and the evidence of infection is only released if somebody "wrings out' the gland by pressing on it very firmly with a gloved finger in a process called "prostate drainage."
Sometimes it takes 3 to 6 drainages, done every other day, before enough material is expressed out to do competent lab work and identify the pathogens involved. Once they've been identified, the pathogens can be eliminated by using only antibiotics shown to be effective against them in the lab dish and continued thrice-weekly drainages.
If you doctor has not identified the organisms causing your disease then your doctor has not been a diligent enough scientist in your case and you should doctor-shop for another one. You wouldn't want a lawyer for an insurance company defending you in a murder trial. You need the right kind of expertise. It isn't easy to find.
Many of us have had to find sympathetic doctors and then virtually teach them the steps on how to cure us. (I'm in the middle of this process myself now.) If you are truly desperate and can afford to spend 6 to 12 weeks out of the U.S. there is a doctor in Manila, The Phillipines who is an excellent scientist and clinician who can probably cure you and help you avoid surgery or irreversible cooking of your prostate gland. His name is Antonio E. Feliciano
and he is for real. Right now there are two dozen north american patients at his clinic. About a half dozen have already returned with good results.
Please, please become an informed consumer of medical help for your prostatitis. Please don't blindly accept what your doctors are telling you. You can and will survive long enough to be cured of prostatitis -- if that is what you have -- without surgery. If you have something else, then really proving that you have no infection in your prostate gland will not take so long. Then you can still have surgery or drasting cooking treatments if that is indicated.
By the way, I predict FDA approval for Microwave thermography of the prostate gland will eventually be withdrawn because of the consequenses of the irreversible process.
Subject: Re: Prostatron Advice
From: Elliott Eckhaus
Date: Tue, 16 Jul 1996 23:08:55 GMT
There have been a number of studies done on the use of Transurethral Microwave Thermotherapy for treatment of BPH, and while it does have some side effects, I guess it may be preferable to the side effects associated with surgery. Anyway............I only found 2 abstracts on it's use for prostatitis, and one of them was writen by none other than Dr Nickels who I believe is helping (along with Brad) to construct the Dr F protocol.
I would imagine if you wanted an opinion, he would be a good place to start. However I have looked at about 40 abstracts on the use of this device and they all seem to have different opinions on what is considered a serios complication. I am including a few abstracts starting with Dr Nickel's.
Nickel JC; Sorensen R Transurethral microwave thermotherapy for nonbacterial prostatitis: a randomized double-blind sham controlled study using new prostatitis specific assessment questionnaires. Queens University, Kingston General Hospital, Ontario, Canada. J Urol 1996 Jun;155(6):1950-4; discussion 1954-5
PURPOSE: We investigated the effectiveness and durability of transurethral microwave thermotherapy in the treatment of chronic nonbacterial prostatitis using 2 new prostatitis specific assessments in a randomized, double-blind, sham controlled trial.
MATERIALS AND METHODS: Patients with nonbacterial prostatitis were randomly assigned to receive either transurethral microwave thermotherapy or sham therapy. Patients were assessed using a symptom severity index and symptom frequency questionnaire. These 2 new prostatitis symptom assessment tools were validated by applying them to 30 similar patients without prostatitis. All nonresponders received transurethral microwave thermotherapy at 3 months and were reassessed at 6 months. Long-term followup of the responder group averaged 21 months.
RESULTS: The symptom severity index and symptom frequency questionnaire were confirmed to be valid for symptom assessment in prostatitis patients. The transurethral microwave thermotherapy group benefited from therapy compared to the sham group. Of the sham group 50% had a favorable response after subsequent transurethral microwave thermotherapy. The 7 responders in the treatment group continued to improve during the subsequent 21 months.
CONCLUSIONS: Transurethral microwave thermotherapy appears to be an effective, safe and durable treatment for some patients with nonbacterial prostatitis unresponsive to traditional therapy.
Lee KT; Tan HH; Li MK; Cheng WS; and others Transurethral microwave thermotherapy (TUMT) for benign prostatic hyperplasia (BPH)--our first 100 cases. Department of Urology, Singapore General Hospital. Singapore Med J 1995 Apr;36(2):181-4
One hundred consecutive cases treated by Transurethral Microwave Thermotherapy (TUMT) since October 1991 were analysed to assess its efficacy and safety. Out of these, 28 were in urinary retention. Patients were selected based on Madsen Symptom Score (MSS), Uroflowmetry, Transrectal Ultrasound Scanning (TRUS) plus biopsy and flexible cystoscopy. In the non-retention group, symptomatic improvement was 81%; mean MSS dropped from 13.6 to 2.6 at one year. Objective improvement was less marked: mean peak urine flowrate (PFR) (+45%), mean residual volume (-63%) and mean prostatic volume (-15%). 8.3% had failed TUMT requiring TURP. In the retention group, 79% was able to void freely after TUMT. Fourteen percent underwent TURP. Based on given criteria, the overall response rate for MSS and PFR averaged 71% at 3 months, 72% at 6 months and 84% at 1 year. Sixty-seven percent of patients who responded to a phone interview were satisfied with TUMT treatment. Minimal morbidity was encountered: temporary retention for non-retention group (24%), UTI (9%), haematuria (7%), impotence (2%) and fistula (1%). There was no treatment-related death. The results showed that TUMT is a viable alternative and safe treatment of BPH.
Choi NG; Soh SH; Yoon TH; Song MH Clinical experience with transurethral microwave thermotherapy for chronic nonbacterial prostatitis and prostatodynia. Department of Urology, HanGang Sacred Heart Hospital, School of Medicine, Hallym University, Seoul, Korea. J Endourol 1994 Feb;8(1):61-4
Chronic prostatitis and prostatodynia are troublesome disorders that are not responsive to any kind of treatment. Patients with treatment-resistant chronic nonbacterial prostatitis (n = 61) or prostatodynia (n = 17) for longer than 3 years underwent a single 1-hour session of transurethral microwave thermotherapy (TUMT) using the Prostatron. Complete symptom disappearance was obtained in 23% of patients and a partial response in 43%. Of the patients with prostatitis, 46% showed normalization and 31% an improvement of the leukocyte count in expressed prostatic secretion. In patients with prostatodynia, the corresponding figures were 35% and 41%. Most complications were temporary, but there was one case of epididymitis and one of reduction in the volume of the ejaculate. TUMT is well tolerated and safe, and it is effective in relieving the symptoms of many patients with nonbacterial prostatitis or prostatodynia. The possible adverse effects on fertility and urinary continence require further study.
Some food for thought Elliott, who is not a Dr and does not pretend to be one
Subject: Re: Prostatron Advice
From: Kerry Ginn
Date: Wed, 17 Jul 1996 10:13:46 -0500
Elliott Eckhaus wrote:
[...] I am including a few abstracts starting with >Dr Nickel's.
I know that "double-blind" means that the researchers who _evaluated_ the test subjects following treatment weren't told which patients got the real treatment and which go the "sham" procedure. I assume that the researchers administering the treatements knew whether or not they were performing the real or the sham procedure, though. Although a bit irrelavant, I cannot help wondering how invasive and how "uncomfortable" the sham procedure was.
-- Kerry Ginn e-mail: KerryGinn@AOL.com
Subject: Re: Prostatron Advice
From: Alan Cocks
Date: Wed, 17 Jul 1996 07:38:02 +0100
I cannot recall seeing any posting from a sufferer who found it a benefit, rather the opposite.
-- Alan Cocks, Berkshire, UK
Demand that your urologist report this to the FDA. It is illegal as well as immoral for a physian not to report a device related adverse reaction. Here are some addresses. I think the FDA has a program called MedWatch which is just for adverse reactions to medical devices.
-- Brad H, MD
- David Kessler, MD
- Food and Drug Administration
- 5600 Fishers Lane (HFC-160)
- Rockville, MD 20857
- Janet Woodcock, MD
- Center for Drug Evaluation and Research
- Food and Drug Administration
- Rockville, MD 20857
Subject: Re: Prostatron treatment
Date: Thu, 9 May 1996 22:42:02 -0400
Anonymous wrote: "I have had Prostatitis for 8-10 years. Among all sorts of medicin I also have tried this Prostatron treatment some years ago with no benefit what so ever.On the contrary, at present I don't gain any EPS using the draining technic of dr. F... The reason is, I hypothese, that the microvaves have destroyed the prostatic tissue and obliterated the prostatic ducts.The result is that the acinis can't be emptied of their content. I'm myself a doctor.From my own personal experience I would not recommend the Prostatron teatment on Prostatitis. "
Please post more on this. I estimate that since the first prostatitis newsgroup started about 6 posts have been done indicating that the Prostatron microwave therapy made the patients worse instead of better. I would not give up on prostatic massage until Dr. Feliciano does it. His manual technique is very detailed and since he has obtained prostatic fluid from men after TURP, he may well obtain it from you. I would suggest that you go to him and see. Semen analyisis can show if you have ducts that are still draining.
Brad H, MD
14405 21st Ave. N.
Plymouth, MN 55447
Phone: (612) 475-1400
FAX: (612) 475-1445
Contact: Dan James, Director of Finance
- Biomedical Field
- Urological devices
- Research and development
- Transurethral thermal therapy technologies
- Technical Support Contact
- Scott Thome, Senior Development Engineer
With Transurethral Microwave Thermotherapy (TUMT)
For men suffering from serious BPH (benign prostatic hyperplasia), or prostatic obstruction, and facing the possibility of the surgical procedure known as a TURP (transurethral resection of the prostate), I would like to describe my recent experience with an obstructed bladder and how I reached a decision to cancel a scheduled TURP and select a non-surgical alternative therapy called a TUMT (transurethral microwave thermotherapy).
For approximately 18 years I had what my personal physician and my urologist described as a 'moderately enlarged prostate.' I had symptoms of BPH, but I was treating it successfully with the herb saw palmetto (which Merck reportedly synthesized to create Proscar). I had more-frequent-than-normal urination, low volume, a weak stream and occasional urgency, but I seldom had to get up more than once at night to urinate. Things seemed under control and I thought that perhaps in 15 - 20 years I would have to have some sort of prostate procedure.
On November 13, 1997, I had major knee surgery under general anesthesia. Anesthesia and narcotic-based, pain-killing drugs given to a patient during and immediately after surgery may cause the prostate to swell and the bladder,s smooth muscle tissue to weaken. This is what happened in my case. In the 48 hours following my knee surgery, my prostate swelled and obstructed the bladder outlet. My bladder was too weak to push the rising volume of urine past the prostatic obstruction and it became distended. I went into retention (that is, I completely lost the ability to urinate) and I had to be catheterized. I was placed on Cipro and Flomax (.8 mg). Over the next month four separate attempts to come off the catheter were unsuccessful and I was scheduled for a TURP on December 19, 1997.
I did not want a TURP because of the near-certainty of retrograde ejaculation following surgery and the possibility, although admittedly small, of impotence, incontinence, internal bleeding and strictures, the latter two of which would require further surgery. However, I saw no alternative to a TUPR other than wearing a catheter for the rest of my life.
Days before my planned TURP I read a magazine article on new medical technologies in Newsweek Extra, Winter 1997-98, page 78. The article contained a reference to a new microwave technique for treating BPH. I cancelled my TURP and got on the Internet. I pulled down a number of files on what I came to understand was called a TUMT (transurethral microwave thermotherapy). I discovered that this technique had been used in Europe and Canada since 1990. In May, 1996, the FDA approved the first TUMT device for use in the U.S. The device is manufactured by EDAP Technomed, Inc. of Burlington, Massachusetts and is called the Prostatron. The Prostatron 2.0 protocol is designed for normal BPH. The Prostatron 2.5 protocol, approved by the FDA in November, 1997, is designed for seriously obstructed cases, such as I had.
Through EDAP Technomed, Inc., (phone: 781-221-1601) I identified a physician in Canada, Dr. Ronald Sorensen, (phone: 800-668-8868) with several years experience using the Prostatron, including 300 procedures with the 2.5 protocol. I was aware that the 2.5 protocol would be available in the U.S. early in 1998, but I did not want to be the first patient through the gate as a new procedure was implemented at a U.S. medical facility. I felt it best to obtain the procedure from someone with substantial experience in the specific procedure I needed. Consequently I flew to Canada and Dr. Sorensen performed the TUMT on me on January 18, 1998.
The FDA has now approved two additional TUMT devices for use in the U.S. They are the Urologix T3 / Targis system, and the Dornier Urowave system. For FDA TUMT approval information call (301) 594-2194.
Below is a comparison of the TURP with the TUMT. I have gleaned the data from a number of sources. Don't hold me to any specific number since there are a variety of studies with differing results. Nonetheless, the general trend shown in the data seems reasonably accurate.
- TURP: General anesthesia or spinal anesthesia.
- TUMT: Local anesthesia in urethra.
- TURP: Two - three days hospitalization for surgery and post-operative recovery.
- TUMT: Outpatient procedure - three hours for preparation, procedure and recovery.
- TURP: Two or more weeks of inactivity following release from hospital.
- TUMT: Resumption of normal activity the day following the procedure.
- TURP: Retrograde ejaculation: more than 90%
- TUMT: Retrograde ejaculation: 2.0 protocol: 0%
- 2.5 protocol: 20%-40%
- TURP: Impotence: +/- 5%
- TUMT: Impotence: 0%
- TURP: Incontinence: +/- 1%
- TUMT: Incontinence: 0%
- TURP: Internal bleeding, serious, requiring intervention: +/- 4%
- TUMT: Internal bleeding, minor, self limiting: 10%-20%
- TURP: Strictures: 4.5%-11%
- TUMT: Strictures: 0%
- TURP: Post -TURP syndrome: +/- 2%
- TUMT: Post-TUMT syndrome: N. A.
- TURP: Retreatment required: 12%-15%
- TUMT: Retreatment required: less than 10%
I did not want to subject myself to any of the risk factors associated with a TURP when a "TUMT produces subjective and objective improvements of BPH symptoms in a comparable range to a TURP." Quoted from "High Energy Thermotherapy versus Transurethral Resection in the Treatment of Benign Prostatic Hyperplasia: Results of a Prospective Randomized Study with 1Year Follow-up." Journal of Urology, 158:120-125, 1997. A synopsis of this article and others may be found on the Internet at: http://www.uroweb.org/literature/index.html.
A TUMT is not surgery. It uses a catheter inserted up the urethra to direct microwaves into the center of the prostate gland killing a small number of cells. As the dead cells collapse and are absorbed, the gland shrinks toward its center, relieving pressure on the urethra. The shrinkage occurs relatively slowly, with maximum shrinkage being achieved around three months but with symptoms sometimes improving for up to a year.
I had been catheterized for three months prior to my TUMT procedure. It was also necessary for me to be re-catheterized following the procedure to allow the swelling of the microwave-treated prostate to recede. I was instructed to leave the catheter in for about two weeks. Out of superstition I chose to go three weeks and removed the catheter on February 9, 1998, my 58th birthday. (I believe catheterization after treatment with the 2.0 protocol may be unnecessary in some cases, or only be necessary for a day or two.) As soon as I removed the catheter I was able to urinate. I was ecstatic. It was my first successful urination in more than three months. Over the next several weeks I experienced steady improvement in the strength and volume of my urination.
Following my TUMT I was advised that I might have to intermittently self-catheterize after I removed the catheter. That proved to be my experience, particularly upon rising in the morning with a full bladder. The bladder fullness apparently put unfamiliar pressure on the system and caused urine flow to nearly cease. However, I only had to self-catheterize upon rising the first two mornings after I removed the catheter. By the third morning I had a good flow. I was also advised that after removing the catheter I should self-catheterize several times to do voiding tests. These tests were to ascertain the residual volume of urine in my bladder following urination. If the residual was over 200cc I was told I would need to intermittently self-catheterize during the day to keep the volume of urine in the bladder below 500cc. If the residual was under 100cc I was told I could stop self-catheterizing. I tested three times after urination and in each case my residual was under 90cc, so I stopped self-catheterizing.
I experienced no pain or discomfort following the TUMT, although after the TUMT there were episodes when I felt extreme urgency to urinate. This lasted 24 hours and was the only discomfort I experienced. There was very minor bleeding after the procedure, which tinged my urine a rosy color. This lasted for several weeks and is normal. At exactly two months after my TUMT my urinary flow weakened and the frequency of urination increased. For a few days I was very concerned that something was not right. One day I self-catheterized to check the residual level in my bladder. I was relieved to find that it was minimal. I called my Canadian urologist's staff and was told that this event was normal. When the 2.5 protocol is used on a serious obstruction, such as I had, the heat at the center of the prostate gland reaches such a level that it kills cells as far out as the urethra lining. As these cells die and are sloughed off, they may obstruct the urethra somewhat and reduce urinary flow. I passed small flecks of dead tissue for about one month. By three months after the TUMT there was no more dead tissue in my urine and my urinary flow was excellent.
My sexual performance has been normal, or actually improving several months after the TUMT. I now produce seminal fluid upon ejaculation at four-to-five times the volume as before the procedure.
In summary, I had a fully-obstructed bladder and had been catheterized for three months prior to my TUMT. The new Prostatron 2.5 protocol was specifically designed for cases like mine and it seems to have worked very well. The cost seemed reasonable to me, but it will vary from place to place. I paid $5,000 for my TUMT, of which my health insurance will cover only a portion since this was an out-of-country procedure.
If you want to consider having a TUMT you will need to shop around for a medical facility near you offering this service. Most U.S. urologists do not yet have experience with the TUMT. Furthermore, some urologists may be resistant to the TUMT. The capital cost of the equipment and the necessity for learning a new technology may cause some urologists to stick to what the urology profession calls its "gold standard" - the TURP. However, based on my personal experience I would echo a second quote from the above-cited article "High Energy Thermotherapy versus Transurethral Resection in the Treatment of Benign Prostatic Hyperplasia etc." To wit:
"...looking...at the results presented by the authors, one might doubt that TURP is a gold standard treatment for BPH. Indeed, with only 43% of patients being improved both in flow and BPH symptoms and 78% when considered symptoms only, we could be more cautious when stating unanimously that TURP, even performed by experienced urologists as in this study, is unequivocally the gold standard (maybe for the urologists, but not necessarily for the patient...)."
I would be happy to correspond with any man interested in my personal experience
with a TUMT. If you wish to contact me, my e-mail address is: email@example.com
One final note. There has been a lot of discussion about laser treatment of BPH. I would say only one thing. Most lasers are just different kinds of knives. They cut. Surgery may be necessary and appropriate for many men, depending on their specific case. However, I suggest any man considering surgery ask a lot of questions, read everything available and explore all the options. There is a great deal of information on the Internet on the TUMT. Just put "TUMT" into your search engine and hit "enter." Some articles you may want to read are:
1. D'Ancona, FCH; Francisca, EAE; et al; "High Energy Thermotherapy versus Transurethral Resection in the Treatment of Benign Prostatic Hyperplasia: Results of a Prospective Randomized Study with 1 Year Follow-up," Journal of Urology, 1997:158:120-125
2. Blute, M. and de Wildt, M; "Transurethral microwave thermotherapy for BPH," Contemporary Urology,1996:8:10
3. Dahlstrand, C.; Geirsson, G.; et al; "Transurethral Microwave Thermotherapy versus Transurethral Resection for Benign Prostatic Hyperplasia: Preliminary Results of a Randomized Study," European Urology, 1993:23:292-298
4. Oesterline, Joseph E., M.D., "Benign, Prostatic Hyperplasia, Medical and Minimally Invasive Treatment Options," The New England Journal of Medicine," January 12, 1995, Vol. 332, No. 2.
5. Politis, G; Pardalidis, N; "Transurethral Microwave Thermotherapy (TUMT) in Benign Prostatic Hyperplasia (BPH) Three Years Later," paper presented at 1996 EAU Congress in Paris, see Internet:http://www.uroweb.org/posters/paris96/98/ind
M. Gregg Smith
October 15, 1998
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