CoreTherm® – What patient is suited?
It is important that the correct diagnosis and treatment indications are present, i.e. that the diagnosis is obstructive BPH and that all absolute and relative contraindications have been identified.
The patient should have:
- Symptomatic BPH
- A prostate size > 30 g
- A prostate length > 35 mm
Investigations
Routine clinical investigations for BPH or LUTS
- Medical history
- Symptom scores (IPSS point score incl. quality of life)
- Micturition information
- Flow measurement
- Physical examination, incl. rectal palpation
- Transrectal ultrasound (TRUL), incl. residual urine measurement
- Urinalysis, incl hematuria and bacteriuria testing
- S-creatinine
- Prostate specific antigen (PSA), recommended for patients under 70 years of age
Possible additional investigations
- Urodynamics evaluation
- Urethrocystoscopy
Absolute contraindications
- strictures and sclerosis (urethra, bladder neck etc.)
- too large/too wide bladder neck (e.g. caused by a prior procedure)
- penis or sphincter implant
- prior pelvic radiation treatment (including prostate brachytherapy)
- bladder cancer
Relative contraindications
CoreTherm therapy can be performed with good effect on obstructive prostates but the following coincident conditions can render the treatment unsuitable or more difficult:
- prostatitis
- untreated UTI
- bladder neck sclerosis
- bladder stones
- bladder diverticula
- prior prostate or rectal procedure
- neurogenic bladder dysfunction (or other bladder emptying problem)
- interstitial cystitis (painful bladder syndrome)
- untreated hypertension
- Parkinson’s Disease
Inform the patient
- that CoreTherm® is an out patient therapy
- that therapy is given using microwaves from a catheter in the urethra
- that therapy takes approx.10-15 min. under local anaesthetic (excl US)
- that urinary urgency and heat sensations may be experienced during therapy
- that an indwelling catheter may be needed for up to three weeks after therapy
- that pieces of tissue may be passed with the urine and that mild hematuria may occur
- that the urinary urgency may occur but will gradually disappear
- that there is a risk of retrograde ejaculation
- that more than 80% of patients notice significant improvement
Additional information
- elevated PSA may occur for some time following CoreTherm®
- provide the patient with the patient brochure
For detailed information please order: The ProstaLund CoreTherm® User Manual