Transurethral Microwave Thermotherapy: How Does It Work?

Abstract

Although some authors have proposed that the favorable impact of transurethral microwave thermotherapy (TUMT) for benign prostatic hyperplasia has only a placebo effect, this idea is inconsistent with the findings of a number of sham-controlled clinical trials. Histologic and immunohistochemical studies have shown that the nerve fibers in the periurethral tissue are damaged or ablated by TUMT, and it appears that the heat affects the innervation of the smooth muscle cells. Among the nerves damaged are the sensory neurons of the posterior urethra, and this change might reduce the excitatory signals from the urethrodetrusor facilitating reflexes. Necrosis and apoptosis within a limited area also have been described. Thus, there is likely more than one basis for the therapeutic effect of TUMT.