The Tomera technique: high energy transurethral thermotherapy with low energy morbidity

Transurethral Microwave Thermotherapy (TUMT) is a unique and promising method of treating benign prostatic hyperplasia. Clinical outcomes after high energy protocol TUMT 2.5 are comparable to transurethral resection of the prostate. Previously this increased efficacy has had greater morbidity than lower energy protocol TUMT 2.0 with catheterization required in all patients. A technique of careful preoperative patient teaching, intravenous ketorolac and remifentanyl; patient discomfort is minimized, bladder spasms avoided, and requirement for catheterization infrequent. In 16 consecutive patients, only four required catheters despite an average energy of 155 KJ and a maximum energy of 208 KJ.