Transurethral microwave thermotherapy: strategies to ensure successful outcomes with Prostasoft 2.0

Transurethral microwave thermotherapy (TUMT) is a unique and promising method of treating benign prostatic hyperplasia. Clinical outcomes are related to thermal dose delivered. In 359 consecutive patients, strategies to increase thermal dose using the FDA-approved Prostasoft 2.0 delivered a mean of 148 kJ, which was almost 50 kJ more than the U.S. FDA trials. These strategies include careful preoperative patient teaching, exclusion of very small prostates, ketorolac, prewarming of the prostaprobe, antitorque of the rectal probe, use of urethral cooling adjustment during power ramping, and no manual power interruptions. Clinical outcomes improved without any significant adverse events. Peak urinary flow increased in 4 months by 5.5 mL/sec.