System and method for treating urinary tract disorders

A method, device, and system for treatment of urinary tract disorders is provided. The device includes a catheter having multiple lumens for insertion into a urinary bladder and for providing fluid flow within the bladder and within the fluid reservoir within the urethra. The device further includes an anchor to be placed within the bladder. A port hub having multiple ports is connected at a proximal end of the catheter. A method of treatment includes providing heated fluid to a urinary bladder and to a fluid reservoir for insertion into an adjacent organ such as the urethra. Simultaneous treatment or separate treatment may be done. Optionally, a medicated solution may be added to the heated fluid. Additionally, pressure may be adjusted so as to optimize the therapeutic effect.

FIELD AND BACKGROUND OF THE INVENTION

The present invention relates to a system and method for treatment of urinary tract disorders and, more particularly, to a device and method for insertion into a urethra and/or bladder that is capable of simultaneously delivering moderate heat, pressure, and/or drugs to provide relief in the pelvic area.

There is a wide array of urinary tract inflammatory disorders, which can generally be broken down into two categories: bacterial and non-bacterial. Bacterial inflammatory disorders are relatively easy to diagnose and treat. Non-bacterial inflammatory disorders are generally less understood, harder to diagnose, and harder to treat successfully. Symptoms usually include pelvic pain or discomfort, urinary urge or frequency, bladder pain, and even pain in neighboring parts of the body such as the abdomen, lower back or thighs. Patients presenting with such symptoms for whom bacterial causes have been ruled out may be diagnosed with one of the non-bacterial disorders. For example, a male disorder called chronic pelvic pain syndrome (CPPS), also known as chronic non-bacterial prostatitis, manifests itself in men as general pain or discomfort in the urethra, perineum, bladder area, penis, testicles, or general pelvic area. Similar symptoms typify another condition occurring mainly in women called interstitial cystitis (female to male ratio approximately 9:1), which is characterized by a non-bacterial chronic inflammatory condition of the bladder or bladder epithelium permeability to toxic agents from the urine.

Both CPPS and interstitial cystitis, which may be related to one another epidemiologically, are treated symptomatically. It should also be noted that it is possible that many men who were diagnosed as CPPS sufferers in reality had interstitial cystitis, and thus, similar treatment may be warranted for both of these conditions. Treatment methods include oral drug therapy, bladder hydrodistension, bladder drug instillation, massage therapy, laser treatments, biofeedback, diet, and even surgery. While some of these methods are partially successful, often the symptoms are not fully alleviated or return shortly after treatment. There are also urinary tract sensory disorders such as overactive bladder or detrusor-sphincter dyssynergia, both of which may be manifested in the urethra and the bladder. Current drug therapies are insufficient, and thus, there is a need for new treatments and treatment methods.

It has been recognized by physicians that applying heat to the prostate may be helpful in easing some of the symptoms associated with CPPS. Heat therapy has been administered in the form of transrectal microwave hyperthermia (temperatures between 41 and 45 degrees Celsius), transurethral microwave hyperthermia, transurethral hot balloon therapy, and transurethral microwave thermotherapy (temperatures over 46 degrees Celsius that cause tissue ablation to exposed tissue).

Hyperthermia treatments have certain advantages, particularly when used in combination with drugs. For example, hyperthermia has been shown to alter intracellular distribution of drugs, while increasing both their metabolism and reaction rates. Hyperthermia provides additional benefits in treatment of cancer, such as transitional cell carcinoma (TCC), or superficial bladder cancer, since it has been shown to increase drug uptake by neoplastic cells while at the same time inhibiting DNA repair in damaged neoplastic cells. However, hyperthermia alone does not necessarily provide long-lasting therapeutic effects because of a lack of sufficient heat supplied by current hyperthermia devices.

It has been shown that heat therapies at higher temperatures, such as transurethral microwave thermotherapy, have better clinical results over the long term, particularly for CPPS. The reason for the beneficial effect is largely unknown, but it has been hypothesized that the higher level of heat in the surrounding non-ablated tissue either improves blood supply or shortens the inflammatory process.

The disadvantage of thermotherapy is that due to the high temperatures near the applicator, a cooling system must be used to protect the urethra while heating the prostate, for example, rendering any system for delivery of thermotherapy relatively bulky and expensive. Additionally, there is a risk of damage to surrounding organs as well as to the prostate itself. Furthermore, microwave heat therapy in particular is problematic in that the radiative energy, which transforms into heat within the tissue, is difficult to control and hard to predict in terms of temperature. Additionally, when hyperthermia is combined with drug treatments, it is essential to avoid excessively high temperatures in order to avoid damage to the drug and its effect on the tissue.

There is thus a widely recognized need for, and it would be highly advantageous to have, a device and method for treatment of CPPS and/or interstitial cystitis for delivery of hyperthermia therapy which is devoid of the above limitations.

SUMMARY OF THE INVENTION

According to a preferred embodiment of the present invention, there is provided a catheter for treating urinary tract disorders. The catheter includes: (a) a catheter body being sized and configured such that when placed within the urinary tract of an individual a proximal portion of the catheter body resides outside the body of the individual, a middle portion of the catheter body resides within a urethra of the individual and a distal portion of the catheter body resides within a urinary bladder of the individual; (b) a fluid reservoir being attached to the catheter body at the middle portion of the catheter body; (c) a first conduit including at least one lumen, the first conduit being for communicating reservoir fluid from a first source outside the body through the proximal portion of the catheter body to the fluid reservoir; and (d) a second conduit including at least one lumen, the second conduit being for communicating bladder fluid from a second source outside the body through the catheter body and into the urinary bladder; wherein the fluid, when heated and provided within the fluid reservoir and/or the urinary bladder enables treatment of urinary tract disorders.

According to yet another aspect of the present invention, there is provided a method of treating a urinary tract disorder in an individual. The method includes simultaneously heating urethral and urinary bladder tissue of the individual for a predetermined time period thereby treating the urinary tract disorder in the individual.

DESCRIPTION OF THE PREFERRED EMBODIMENTS

The present invention is of a device and method for treating urinary tract disorders. Specifically, the present invention can be used to improve hyperthermia treatment of symptoms of a urinary tract condition, such as CPPS or interstitial cystitis, by increasing heat circulation in the pelvic area while not subjecting any organs to a potentially damaging level of heat.

Prior art devices either lack sufficient heat circulation to provide any long-term benefits, or are configured to deliver treatment at relatively high temperatures. Those that use high temperatures either potentially cause damage to surrounding tissue or these effects must be counteracted with a cooling device.

An example of a prior art device for thermal treatment is disclosed in U.S. Pat. No. 5,257,977 to Eshel. The device described therein is an insulated catheter for insertion into a narrow body orifice such as the urethra. It is used to provide heated fluid under pressure to the urethra or the bladder. Although it is suitable for hyperthermia treatment as well as ablative heat treatment, the heat applied to the treated tissue by hyperthermia treatment is not sufficient so as to provide long-term benefit.

Another example of a prior art device for thermal treatment is disclosed in U.S. Reissued Pat. No. 37,315 to Lev. The device described therein is designed for hyperthermia therapy of tumors by means of microwave radiation. It includes a catheter with a sheathed radiofrequency antenna, surrounded by a flow of liquid and an inflatable balloon. The catheter is introduced into the bladder through the urethra. The liquid, which optionally includes a cytotoxic substance, is circulated through the bladder while the bladder is then heated through.

Disadvantages of hyperthermia treatments such as the ones described are that insufficient temperatures are used to provide long-lasting therapeutic effects. Particularly with respect to radiative energy, which is difficult to control, temperatures are generally kept on the low-end, to avoid tissue damage by undetected, higher than monitored temperatures. The use of these low-end temperatures may provide inferior results.

The present invention seeks to overcome the disadvantages of the prior art by providing either simultaneous or sequential heat treatment to more than one organ within the urinary tract. By providing simultaneous hyperthermia treatment of the urethra or prostate and the bladder, better clinical outcomes can be achieved, even without additional therapy such as drugs, pressure or radiation. The rationale for this type of treatment is that more conductive heat can be provided to the region as a whole without the need for an increase in temperature to the ablative level. Furthermore, since the diagnosis of some urinary tract disorders is not always clear, and due to the overlapping nature of diseases such as CPPS and interstitial cystitis, and the involvement of both the bladder and urethra in detrusor-sphincter dyssynergia, treatment of more than one organ may be helpful since the disease might be originating from both or either location.

The principles and operation of a device and method according to the present invention may be better understood with reference to the drawings and accompanying descriptions.

Thus, according to one aspect of the present invention there is provided a catheter for treating urinary tract disorders in an individual. As is further described hereinunder, the catheter of the present invention is designed and configured so as to allow simultaneous heating of both the urethra and bladder of the individual thus providing substantial treatment benefits to individuals suffering from urinary tract disorders such as CPPS, interstitial cystitis, detrusor-sphincter dyssynergia, overactive bladder, and superficial bladder cancer (TCC).

Reference is now made toFIG. 1, which is a cross-section illustration of a device10in accordance with one embodiment of the present invention. Device10includes a catheter12having a distal portion14, a middle portion15, and a proximal portion16, and a fluid port hub17at proximal portion16of catheter12. Distal portion14of catheter12is designed to be inserted into a urinary bladder13, and includes a bladder inlet opening36and a bladder outlet opening37for fluid flow within urinary bladder13, and an anchor40for holding catheter12in place and for preventing outward migration of device10once it is situated in the body. An anchor opening46allows for fluid flow into and out of anchor40. In a preferred embodiment, anchor40is an inflatable balloon, which can be inserted into urinary bladder13while deflated and can subsequently be inflated so as to anchor catheter12into place. In alternative embodiments, anchor40is of another configuration, such as a malecot. Middle portion15of catheter12includes a fluid reservoir20with a reservoir inlet opening26and a reservoir outlet opening27, for fluid flow within fluid reservoir20. In a preferred embodiment, fluid reservoir20is an inflatable balloon. In alternative embodiments, fluid reservoir20is a bladder or a membrane. In one embodiment, fluid reservoir20is comprised of permeable or semi-permeable material to allow diffusion of particles, including drugs or medicaments.

Middle portion15of catheter12is designed to be inserted into a urethra.FIG. 1depicts catheter12as located with respect to male anatomy, whileFIG. 2depicts catheter12with respect to female anatomy. As shown inFIG. 1for a male, fluid reservoir20of middle portion15is positioned within the urethra11, which is within a prostate19. In one embodiment, fluid reservoir20extends into and beyond the external sphincter18. As shown inFIG. 2for a female, fluid reservoir20of middle portion15is positioned within urethra11, and extends through the sphincter18. In one embodiment, fluid reservoir20extends past urethra11and through the area of the female genitalia29. It should be readily understood that fluid reservoir20of middle portion15of catheter12is designed to be used throughout the region of the urinary tract, and is not limited to any specific organ or segment thereof.

At proximal portion16of catheter12, fluid port hub17includes a series of ports for fluid movement within catheter12. In a preferred embodiment, the following ports are included in fluid port hub17: reservoir inlet port22; reservoir outlet port23; bladder inlet port32; bladder outlet port33; and anchor port42. Each port is connected to a corresponding lumen or conduit within catheter12, as shown in a cross-sectional view along section A-A of catheter12depicted inFIG. 3. Thus, reservoir inlet port22is connected to reservoir inlet lumen24; reservoir outlet port23is connected to reservoir outlet lumen25; bladder inlet port32is connected to bladder inlet lumen34; bladder outlet port33is connected to bladder outlet lumen35; and anchor port42is connected to anchor lumen44. These lumens, in turn, are connected to openings in various locations on catheter12, as follows. Reservoir inlet lumen24is connected to reservoir inlet opening26; reservoir outlet lumen25is connected to reservoir outlet opening27; bladder inlet lumen34is connected to bladder inlet opening36; bladder outlet lumen35is connected to bladder outlet opening37; and anchor lumen44is connected to anchor opening46. In alternative embodiments, more or fewer ports and lumens may be used.

Fluid circulates throughout device10, both freely within urinary bladder13, and within fluid reservoir20, providing pressure, heat, medication or a combination thereof to the various areas within the urinary tract. Reservoir inlet port22provides fluid through reservoir inlet lumen24and out through reservoir inlet opening26into fluid reservoir20, thereby expanding fluid reservoir20within urethra11. Fluid from fluid reservoir20exits through reservoir outlet opening27, and returns through reservoir outlet lumen25within catheter12and reservoir outlet port23. In one embodiment, the fluid flowing into and out of fluid reservoir20is a gas. In a preferred embodiment, the fluid flowing into and out of fluid reservoir20is a liquid, such as water or saline solution, and may further include drugs. Bladder inlet port32provides fluid flow through bladder inlet lumen34and bladder inlet opening36into urinary bladder13. Fluid circulates through urinary bladder13and returns via bladder outlet opening37through bladder outlet lumen35and exits through bladder outlet port33. In one embodiment, the fluid flowing into and out of the bladder is a sterile liquid, such as water. In a preferred embodiment, the fluid flowing into and out of the bladder is a sterile liquid, such a saline solution. In an exemplary preferred embodiment, the fluid flowing into and out of the bladder is an augmented sterile liquid, such as sterile water augmented with medication, as will be described in further detail hereinbelow. Anchor port42provides fluid through anchor lumen44via anchor opening46into anchor40, thereby expanding anchor40so as to hold catheter12in place. Thus, anchor40is meant to stay inflated throughout a procedure using device10, and once the procedure is completed, the fluid is removed via anchor opening46through anchor lumen44and anchor port42. Since fluid does not circulate throughout the procedure, only one lumen is needed.

Reference is now made toFIGS. 4–6, which illustrate a cross-sectional view of fluid port hub17with and without temperature sensors50,60inside reservoir inlet housing28and bladder inlet housing38, respectively.FIG. 4illustrates fluid port hub17without temperature sensors50,60;FIG. 5is an illustration of a temperature sensor50or60, according to an embodiment of the present invention; andFIG. 6illustrates fluid port hub17with temperature sensors50,60placed therein. According to alternative embodiments, only one, or neither of the ports have a temperature sensor50or60located therein.

As shown inFIG. 4, reservoir inlet port22is designed within reservoir inlet housing28and bladder inlet port32is designed within bladder inlet housing38. Housings28,38include temperature sensor membranes52,62, respectively. For purpose of discussion, only reservoir inlet housing28, with temperature sensor membrane52and reservoir inlet port22will be described in detail, but it will be readily understood that bladder inlet housing38, temperature sensor membrane62and bladder inlet port32have a similar or identical configuration. Temperature sensor membrane52is comprised of an elastic material, such as silicon, PVC, polyurethane or any other suitable material. Membranes52,62have tips53,63and entrances51,61to receive temperature sensors50,60. Reservoir inlet port22is configured for introduction of fluid into reservoir inlet lumen24. Fluid introduced therein surrounds temperature sensor membrane52while being introduced into reservoir inlet lumen24.

When temperature sensor50is placed into reservoir inlet housing28through entrance51, tip53of temperature sensor membrane52is configured to extend inwards, thereby elongating membrane52so as to provide a snug fit of temperature sensor50within temperature sensor membrane52, as seen inFIG. 6. In a preferred embodiment, temperature sensor50is cone-shaped, enabling ease of entry almost fully into reservoir inlet housing28, followed by a close fit due to the deformation of temperature sensor membrane52.

Temperature sensors50,60are fabricated from a metal such as stainless steel, within which is placed a temperature sensing device such as a thermocouple junction, thermistor, or PT100device.

Temperature sensors50,60are designed to measure the temperature of the fluid inserted into fluid reservoir20and/or urinary bladder13. In this way, the temperature of fluid flowing through device10can be monitored and adjusted. In one embodiment, the optimal temperature is 41–46 degrees Celsius. In a preferred embodiment, the optimal temperature is 44 degrees Celsius. In alternative embodiments, temperature sensors50,60are located within fluid reservoir20or inside distal portion14or within the urinary bladder13.

Reference is now made toFIG. 7, which is an illustration of a urinary tract treatment system100including a heating device80, in accordance with one embodiment of the present invention. Heating device80is connected to port hub17via several fluid connections using tubing (shown inFIG. 7as solid lines) and electrical connections using wire (shown inFIG. 7as dotted lines), and includes a controller82, a set of peristaltic pumps56,66, and a set of fluid heating systems54,64. Electrical connections are present between controller82and temperature sensors50,60, peristaltic pumps56,66, and fluid heating systems54,64. Heating device80, located outside the body, administers and controls heat and pressure to the fluid flowing throughout device10. Two heating loops are formed, on each side of heating device80. One loop heats fluid which has returned from fluid reservoir20before sending it back into fluid reservoir20, and the other loop heats fluid which has returned from urinary bladder13before sending it back into urinary bladder13. Thus, in both locations, newly heated fluid consistently replaces cooled fluid returning from inside device10. The loops can continue for as long as the user desires.

Referring first to the heating loop for fluid reservoir20, fluid coming from reservoir outlet port23flows into heating device80. Within heating device80, it flows through a peristaltic pump56, and through a fluid heating system54. Fluid then flows out of heating device80and into reservoir inlet port22. Temperature sensor50measures the incoming fluid and sends feedback to controller82, allowing the temperature to be adjusted for the subsequent stream of fluid. Temperatures are closely monitored and controlled by controller82. Fluid enters (and exits) urinary tract treatment system100via filling ports55,65. Filling ports55,65are also used to adjust pressure or provide alternating pressures within each loop of system100. This can be accomplished, for example, by placing a column of fluid over system100wherein the column is connected to filling port55or65, and thereafter changing the height of the column. At the end of treatment, fluid is removed from both loops of system100through filling ports55,65.

Similarly for the second heating loop for urinary bladder13, fluid coming from bladder outlet port33flows into heating device80. Within heating device80, it flows through a peristaltic pump66, and through a fluid heating system64. Fluid then flows out of heating device80and into bladder inlet port32. Temperature sensor60measures the incoming fluid temperature and sends feedback to controller82, allowing the temperature to be adjusted for the subsequent stream of fluid. Temperatures are closely monitored and controlled by controller82.

Peristaltic pumps56,66can be any pump known in the art, such as Masterflex L/S catalog number TH-77910-20 from Cole-Parmer Instrument Company (Vernon Hills, Ill., USA), or 313 FAC/D OEM pump from Watson-Marlow Bredel Pumps (Wilmington, Mass., USA). Controller82can be any suitable controller, such as a standard PC board, or ATR 110 Controller Single Setpoint or ATR 240 Controller Double Setpoint from Pixsys (Padua, Italy). Fluid heating systems54,64will be described in greater detail hereinbelow.

Reference is now made toFIGS. 8–14, which illustrate a fluid heating system54or64from heating device80, in accordance with a preferred embodiment of the present invention. InFIGS. 8–10, fluid heating system54or64includes a heating element84and a heat exchanger bag70for placement over heating element84. In a preferred embodiment, heating element84is cone-shaped. Heating element84can alternatively be pyramidal or any other shape which is symmetrical along one axis and asymmetrical along a perpendicular axis. In another embodiment, heating element84is cylindrical.

FIG. 8illustrates heat exchanger bag70in a flat configuration. By using a bag for heat exchange, a greater area is available for heat dissipation, resulting in smaller temperature gradients that do not harm the medications included within the fluid. In its flat configuration, heat exchanger bag70can be defined as a partial sector of a circle, with a central arc B and a radius L having edges73,74and inlet/outlet tubes75,76. In a preferred embodiment, heat exchanger bag70is a bag or sack having therein a loop configuration of passageways71for fluid flow. As shown inFIG. 8, passageways71are constructed in a zigzag or “S” configuration, or any other suitable configuration for fluid77to pass through and either gain or release heat along the way. Fluid77flows into and out of heat exchanger bag70through inlet/outlet tubes75,76. In use, heat exchanger bag70is folded into a cone shape with overlapping edges73,74, and welded along this line, as shown inFIG. 9.FIG. 9shows the folded cone-shaped heat exchanger bag70andFIG. 11shows heat exchanger bag70after placement on a heating element84. Heat exchanger bag70may be made from polyurethane, PVC, or any other suitable material.

An advantage to having a cone-shaped heating element84and a cone-shaped heat exchanger bag70, is that heat exchanger bag70can be easily placed on heating element84, after which a close fit is obtained, thereby providing even heating of the fluid flowing within heat exchanger bag70. In order to provide this self-holding taper, a vertical angle A of the cone should preferably be between 1 and 4 degrees. In an exemplary preferred embodiment, the vertical angle A is 2 degrees. In order to obtain an angle A, heat exchanger bag70must be constructed of a particular circle sector with circle radius L and arc B. The radius of the base of the cone is r and the length of the cone is equal to the circle radius L. These parameters are related to each other as follows:
r/L=sinA.

The length of arc B is (B/360)*2πL.

Thus, (B/360)*2πL=2πr (which is the circumference of the cone base)
B=360(r/L)=360 sinA.

Heat exchanger bag70in its flat configuration, as shown inFIG. 8, can be defined as a modified sector, wherein the modification includes removal of an upper portion of the sector. However, all parameters remain as described above.

Reference is now made toFIGS. 10–13, which are illustrations of heating element84, heating element84with heat exchanger bag70placed thereon, and heating element84with heat exchanger bag70, a cover90, and cover90placed on top of heat exchanger bag70, respectively. Heating element84is designed so as to accept heat exchanger bag70placed thereon. In a preferred embodiment, heating element84has a structural element on a portion of it, such as a beveled top, for providing a close fit to cover90and thereby trapping air in heat exchanger bag70, as will be described in further detail hereinbelow. As shown inFIG. 10, heating element84is usually made of aluminum and has therein one typical cartridge heater85such as FIREROD cartridge code number G4A54 from Watlow (St. Louis, Mo., USA) and a heating element temperature sensor86. As shown inFIG. 11, heat exchanger bag70fits closely on top of heating element84.

Once heat exchanger bag70is placed onto heating element84, fluid77is introduced into system100via filling ports55,65. As fluid77is circulated through system100, air rises to the top of heat exchanger bag70. Cover90, shown inFIG. 12, is then placed on top of heat exchanger bag70, locking in the trapped air so as to allow fluid77to be substantially free of unwanted air, as shown inFIGS. 13 and 14.

Reference is now made toFIGS. 13 and 14, which illustrate fluid heating system54,64in greater detail. In a preferred embodiment, heating element84is cone shaped and has a bevel87, and cover90is cone-shaped, and has a bevel97configuration to match bevel87of heating element84. The bevel of cover90is at an angle with respect to the rest of the outer portion of cover90and of heating element84. In one embodiment, the angle is between 20 and 70 degrees. In a preferred embodiment, the angle is approximately 45 degrees, as shown inFIGS. 13 and 14. Heat exchanger bag70is sandwiched between heating element84and cover90. The size of the gap between heating element84and cover90determines the thickness of the stream of fluid77within heat exchanger bag70. A goal is to minimize this thickness, so that fluid77is more evenly heated. In a preferred embodiment, the thickness is 1–3 millimeters. By providing a bevel at an angle, the size of the gap is set at a certain amount. Additionally, after initial fluid circulation in the priming stage, cover90is lowered down until bevel97of cover90meets bevel87of heating element84, thus causing the bevel to choke the upper portion of heat exchanger bag70, thereby trapping any air78found therein so that the fluid flow is free of unwanted air as it circulates through the system100. Furthermore, without the additional compressible component of air, the pressure of fluid77can be manipulated more accurately.

A method for treatment of urinary tract disorders using the described device can include various therapeutic regimes, as will be described in further detail hereinbelow. The device of the present invention is designed so as to enable simultaneous treatment of a urinary bladder and an adjacent organ, such as the urethra. In addition, various combinations of heat, pressure and medication may be used in both the bladder and the urethra, either individually or in combination.

In one embodiment of the present invention, both the urinary bladder and the urethra are simultaneously heated, by heating the fluid flowing in and out of the corresponding lumens. In a further embodiment, medication may be added to the heated fluid. Examples of medications include, but are not limited to cytotoxic drugs such as mitomycin C or anti-inflammatory drugs such as heparin, or nerve desensitizing drugs such as resiniferatoxin. In yet a further embodiment, a pressure may be increased through filling ports55,65. The pressure may be a single continuous pressure, or alternatively, there may be several alternating pressures. Either of these types of pressures can be added to heated fluid with or without medication.

In other embodiments, the urinary bladder and the urethra are heated sequentially without changing catheter12, which serves to ease treatment to the patient. The same possible combinations of heat, pressure, alternating pressure, and medication, can be used for each organ separately.

By combining heat treatment of the urinary bladder with heat treatment of the urethra, the effective heat generated in the area is improved without damaging surrounding tissue through the use of too high temperature as in thermotherapy. Specifically with respect to CPPS, interstitial cystitis, and TCC, generalized heating of the area may contribute to longer lasting effects of treatment. For illnesses which have unclear etiologies, such as CPPS and interstitial cystitis as well as detrusor-sphincter dyssynergia, simultaneous or sequential heating can aid in treatment by providing heat to several organs, allowing for the possibilities that either the urinary bladder or the urethra or both are problematic areas. Each of these treatments can be further adjusted according to need, based on temperature, pressure and medication. Thus, the methods described herein provide a broader range of treatments over a larger area with potentially longer lasting effects.