About CoreTherm® and the procedure
What is CoreTherm®?
CoreTherm® used to be called ProstaLund Feedback Treatment (PLFT) and is an improved form of microwave therapy. Microwave therapy is often called TUMT (Transurethral Microwave Therapy) in the medical literature. The therapy involves inserting a catheter into the patient’s urethra. The catheter contains an antenna that emits microwaves. The microwaves heat the prostate tissue nearest to the urethra, which kills the tissue cells. It is important that the correct temperature is reached for the therapy to be effective.
What differences are there between normal Transurethral Microwave Therapies (TUMT) and CoreTherm®?
CoreTherm® is the next generation TUMT, where the temperature in the prostate is monitored during the entire treatment. Normal TUMT uses a predetermined treatment time and microwave power, without measuring the temperature in the prostate during the procedure. When CoreTherm® therapy is carried out the physician can adjust both the microwave power and the treatment time based on the actual temperature reached in the individual patient’s prostate. For a good outcome it is important that the correct temperature is used for the therapy, so unnecessary injury is avoided.
Is microwave therapy a new method?
No, not at all. BPH has been treated using microwaves since the beginning of the 1990s. This year alone it is estimated that around 100,000 patients worldwide will be treated using different types of microwave therapy. In Sweden more than 500 patients are treated annually.
What is PLFT?
PLFT is a name that is no longer used. It is an acronym for ‘ProstaLund Feedback Treatment’. ‘Feedback’ refers to the data fed back to the treating physician about the actual temperature in the tissue throughout the therapy, the amount of tissue coagulation and the changes in intraprostatic blood flow during the therapy. Now the therapy is simply called CoreTherm®.
What are the differences between CoreTherm® and other microwave therapies?
CoreTherm® allows better treatment control than other devices on the market. Its unique properties and patented design make it the most advanced minimally invasive procedure currently available for BPH therapy. No other minimally invasive microwave therapy system has the same performance capabilities.
Which patients can be treated?
The majority of patients diagnosed with BPH can be treated with microwaves and CoreTherm®, but there are exceptions. Exceptions are patients with:
- strictures and sclerosis (urethra, bladder neck etc.)
- a too large/too wide bladder neck (e.g. caused by a prior procedure)
- penis or sphincter implants
- a history of pelvic radiation treatment
- bladder cancer
How effective is CoreTherm® compared to surgery?
Scientific studies show that CoreTherm® is as effective a therapy as surgery (TURP). CoreTherm® is associated with fewer risks and is easier for the patient to undergo. The therapy can be given at a clinic and no inpatient hospitalisation is needed.
What examinations must be carried out prior to CoreTherm® therapy?
Therapy with CoreTherm® should be preceded by an examination carried out by a urologist. The examination should confirm that BPH is the cause of the patient’s symptoms. The examination includes an IPPS questionnaire, measurement of urine flow, ultrasound examination of the prostate and rectal palpation of the prostate. Urethrocystoscopy may also be required.
Is a general anaesthetic or spinal anaesthesia given during the therapy?
No. CoreTherm® is carried out under local anaesthetic. Preferably a Schelin catheter is used to administer intraprostatic anaesthetic and adrenaline. Not applicable in US, pending FDA´s approval. In this way there is no, or only minimal, blood flow in the prostate during therapy. If required the patient may be given analgesia and a tranquilizing agent. The patient remains conscious during the entire procedure and you can monitor the patient’s condition throughout.
Will the patient experience discomfort or pain during the procedure?
Most patients do not perceive the procedure to be painful. It is however usual for patients to feel some discomfort and sensations of urinary urgency. How much discomfort the patient experiences differs from patient to patient and it is therefore important that you talk to your patient during the entire procedure.
CoreTherm® post treatment
Can the patient go home directly after the therapy?
Yes. The treatment itself takes about 10-15 minutes and you can normally discharge the patient after a few hours. Depending on use of anaesthesia method.
Will the patient feel discomfort after the procedure?
Some patients don’t feel any discomfort after therapy, while others experience urinary urgency. This is due to the prostate becoming irritated and swollen, but this will gradually disappear. Some patients feel urinary urgency to be a problem, especially during the first few days after therapy. The problem becomes less as the swelling goes down and then disappears completely.
Does the patient need a catheter after the procedure?
Yes. Following therapy your patient will need an indwelling catheter for a while. You as the patient’s physician must determine for how long, but 2-4 weeks are recommended depending on which catheter is used and the general health of the patient.
Does the patient need medication following therapy?
It is not unusual to prescribe an antibiotic following therapy to avoid urinary tract infections whilst the patient has an indwelling catheter. For a few days after the procedure some patients need analgesia. Discuss such needs with the patient. In the long-term no medication is needed following CoreTherm® therapy.