eMedicine - Transurethral Microwave Thermotherapy of the Prostate (TUMT) : Article by Jonathan Rubenstein, MD: "Contraindications: Several general contraindications to all prostatic surgeries exist, such as active urinary infection or known or suspected prostate or urothelial cancer. Consider each of these before a treatment plan is instituted. Patients with neurogenic bladder voiding dysfunction should have their underlying neurogenic problem evaluated and treated.
Contraindications specific to TUMT are evolving as the technology changes and outcomes are studied further. Patients with a history of TURP or pelvic trauma should not undergo TUMT because of potential alterations in pelvic anatomy. Patients with glands that are smaller than 30 g or a prostatic urethral length of less than 3 cm respond poorly to TUMT, as do patients with glands greater than 100 g and patients with a prominent median bar.
Other contraindications include patients with metallic implants, penile prosthesis, severe urethral stricture disease, Leriche syndrome and/or severe peripheral vascular disease, or an artificial urinary sphincter. Patients with pacemakers need clearance from their cardiologists concerning turning their pacemakers off during therapy, although performing TUMT in this group should be approached with apprehension.
Hip replacement is no longer a contraindication. Acute urinary retention previously was thought to be a contraindication to TUMT. However, high-energy TUMT has shown promising results in this population, although efficacy has yet to be determined. Patients presenting in retention tend to be ill, with greater comorbidities; thus, they might benefit from the less invasive nature of TUMT."
