CONTRAINDICATIONS
All patients undergoing transurethral procedures must have a documented sterile urine culture and must be evaluated for prostate or urothelial cancer if clinically suspected. 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 25 gm. or a prostatic urethral length of less than 3 cm respond poorly to TUMT, as do patients with glands greater than 100 gm or patients with a prominent median bar.
Other contraindications include patients with penile prosthesis, severe urethral stricture disease, Leriche syndrome/severe peripheral vascular disease, or an artificial urinary sphincter. Patients with pacemakers and defibrillators need clearance from their cardiologist concerning turning their pacemakers off during therapy.
Hip replacement is no longer a contraindication. Acute urinary retention was previously thought to be a contraindication to TUMT; however, high-energy TUMT has shown to be promising in this population, although efficacy has yet to be determined
