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Male Health

Microwave Thermotherapy - Rational Treatment for Prostate Enlargement

Stephen A. Sacks, MD, FACS

"Urologix", a Minnesota-based technology company has selected Tower Urology Medical Group (TUMG) to represent its state-of-the-art "Targis" thermotherapy system for the treatment of symptomatic prostate enlargement (BPH). Tower Urology Medical Group has agreed to be the exclusive Urologix resource site in Southern California, and in addition to treating patients and submitting research data, TUMG will tram and certify community urologists in all clinical applications of microwave technology.

The Targis system includes instrumentation that provides a computer-mediated microwave delivery system (MDS), a unique catheter with a patented helical dipolar antenna and cooling system, and thermosensing receptors m the urethra and rectum (RTU).

The rationale for the establishment of alternative treatments for benign prostatic hyperplasia (BPH) is based upon the knowledge that nearly all men over the age of 40 develop BPH, and that a large percentage of these men will complain of symptoms significant enough to warrant recommendations for medical or surgical intervention. In the context of an aging population with increasing numbers of symptomatic men, intelligent management strategies for the treatment of BPH has become a major epidemiological challenge.

Surgery has long been the mainstay of treatment for symptomatic men with BPH, and as recently as 1985, approximately 30% of this subpopulation of men could expect to have surgery for this condition at sometime during their lives. The subjective and objective results (outcomes) of surgery for BPH inarguably provide for the best and most durable relief of symptoms, Unfortunately, however, surgery for BPH is relatively expensive (four billion Medicare dollars in 1988) and is known to be accompanied by infrequent but unacceptable side effects and complications.

The advent of medical strategies for BPH has revolutionized the management of men with symptomatic BPH. Effective and well tolerated, the use of "alpha blockers" (Hytrin, Cardura, Flomax) has been convincingly demonstrated to significantly reduce the bothersome symptoms of BPH in many men, and, m addition, the use of "5-alpha reductase inhibitors". (Proscar) may also be effective in some men. The disadvantages of medical therapy include the occasional adverse consequences of medications (low blood pressure, generalized weakness, reduced energy, and sexual problems) and a commitment to a lifetime of drug treatment.

Microwave Thermotherapy appears to potentially fulfill that criteria for an ideal BPH treatment for the following reasons:

The procedure is designed to be accomplished in an office or outpatient setting. No hospitalization is required.
Only local anesthesia is used, Most patients will read or watch television during the procedure and are encouraged to be accompanied by family members.
The "Targis" system generates intense heat (greater than 45 degrees centigrade) to a targeted area of the prostate gland which ultimately will result in "coagulation necrosis" and shrinkage of the affected tissues.
The onetime treatment duration is 60 minutes. The time required to reach therapeutic temperatures approximates 20 minutes, and the "cool down" time is 10 minutes so that the entire session lasts approximately 90 minutes.
In most instances, a urethral catheter is left indwelling for only two to three days minimizing the potential complications of prolonged catheterization.
Unlike other therapies, Targis Microwave Thermotherapy does not cause the prolonged sloughing of devitalized tissue, but instead appears to result in the gradual reabsorption (shrinkage) of targeted tissue while maintaining the integrity of the urethral lining.
There have been virtually no instances of hemorrhage, erectile dysfunction, retrograde ejaculation or urinary incontinence, and no rectal injuries.

The Urologix Targis System is a well-conceived and thoughtfully implemented mechanism for the administration of microwave thermotherapy which is reliable, safe, and effective. Additional information is available at the Urologix web site.

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