Benign Prostatic Hyperplasia

Treatment - MIST Therapies

A number of so-called minimally invasive surgical therapies or MIST therapies have recently been developed for the treatment of lower urinary tract symptoms and BPH.

• Microwave Thermotherapy
• Transurethral Needle Ablation (TUNA)
• Interstitial Laser Thermal Therapy (INDIGO)

Microwave Thermotherapy

Microwave thermotherapy operates on the basis of heat administration to the prostate. The heat is administered through a microwave antenna that is placed through the urethra into the prostate itself. The microwave energy is generated outside the body and the prostate is heated from within for approximately 60 minutes. A water cooling system surrounding the antenna protects the urethral lining and makes sure that you don’t feel too much discomfort during the actual treatment. Inside the prostate, the heat induces damage to the tissue which eventually will die and be absorbed by the body. In this manner, the prostate shrinks, and the symptoms improve as well as the urinary flow rate.

Among the companies in the United States producing microwave thermotherapy devices is Urologix which makes 2 devices called TARGIS and Prostatron. Both machines are capable of delivering microwave energy to the prostate and have been proven in long term studies to provide symptom and flow rate improvement with very few complications.

There are 2 other companies manufacturing microwave devices and it is likely that these devices also will be approved by the FDA in the near future provided that they have stood the test of time and proven efficacy in clinical trials. These companies are Prostalund (Sweden) and a device called Thermatrix.

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Transurethral Needle Ablation (TUNA)

Another way to administer heat to the prostate is by using radiofrequency energy. The radiofrequency energy is again generated outside the body and the energy is administered to the prostate through the urethra. Under direct vision using a telescope, the physician inserts very small needles into the prostate and then turns on the radiofrequency energy. The energy delivers heat into the prostate and again, the tissue is damaged, eventually absorbed inducing shrinkage of the prostate and improvement in the symptoms.

The TUNA device is manufactured by the VidaMed company and is approved for the treatment of BPH by the FDA.

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Interstitial Laser Thermal Therapy (INDIGO)

Another approach to deliver heat to the prostate is the use of laser energy.

Ethicon Endosurgery produces a laser called Indigo that operates in a similar principle as the TUNA device. Under direct vision, a laser fiber is inserted into the prostate, the laser energy is turned on, and the tissue again is damaged, and eventually absorbed leading to improvement in symptoms and urinary flow.

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More information:

Medications

Investigational

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For more information about the Department of Urology, contact:

Phone: 214-648-4765, FAX: 214-648-4789

Mailing Address:  5323 Harry Hines Blvd., Dallas, TX  75390-9110