It may also decrease the tone of the prostate by destroying alpha adrenoreceptors. This factor is important because the symptoms experienced by the patient may not always be directly correlated with an increase in prostate size. Both the tone and the bulk of the prostate can be responsible for urinary obstructive symptoms. Transurethral thermotherapy of the prostate is administered through a urethral catheter which embodies a helical microwave antenna, thermometry, and a lumen to allow continuous circulation of chilled sterile water around the antenna throughout the procedure. Most complications of thermotherapy are transitory but include acute urinary retention, urinary tract infection, hematuria, dysuria, hematospermia, acute incontinence, rectal or urethral discomfort, and worsening of urinary symptoms.
Patients can expect improved urination approximately four to six weeks after thermotherapy.
Although catheter design and temperature settings contribute to treatment tolerability, patients will voice complaints of discomfort such as a burning or stinging sensation at the tip of the penis, a sense of urgency, occasional bladder spasms, rectal fullness, or a vague, diffuse heaviness or pressure in the pelvic area. At times, patients will appear restless, but are unable to describe actual discomfort. These complaints usually begin within 15-20 minutes after the initiation of microwave power at 20 to 25 watts of microwave power, peak approximately 30 minutes into the therapy when the urethral temperature reaches 38.5 degrees C., and vanish when microwave power is terminated, without residual discomfort. Maximum discomfort as reported by the patient rarely endures for the entire therapy, but will occur early in therapy and last for 10-15 minutes. On rare occasions, the treatment may need to be aborted for patient intolerance.