Water-Induced Thermotherapy (WIT) - Water-induced thermotherapy (WIT) is the most recent development in the treatment of non cancerous, enlarged prostate. This innovative procedure was developed during the 1990s and received FDA approval in 1999. WIT is a minimally invasive outpatient procedure that is less complicated than other treatments for BPH. WIT effectively destroys excess prostatic tissue, which presses on the urethra and compromises urinary flow, and thus reopens the urethra. WIT has its advantages: it can be performed in ambulatory surgery, outpatient surgery, or a physician's office; it takes only 45 minutes and does not require general anesthesia, and therefore does not carry the risks associated with inpatient surgery; and it does not produce incontinence or impotence, common effects of surgical treatments for BPH. The Procedure - Before the day of the procedure, the urologist measures the size of patient's prostate in order to select the size of the catheter. The catheter is made up of four contiguous sections: the urinary drainage lumen, the positioning balloon, the treatment balloon, and the insulated shaft. On the day of the procedure, the urologist inserts Lidocaine gel, an anesthetic, into the urethra to control pain. Next, the computer console, to which the catheter is attached, heats the water to 60° C (140° F). The urologist inserts the catheter through the urethra, through the center of the prostate, and into the bladder. Once the urinary drainage lumen and the positioning balloon reach the bladder, the positioning balloon inflates, thereby securing the catheter. Urine is allowed to pass by means of the urinary drainage lumen for the duration of the procedure. The treatment balloon, resting in the prostatic urethra (located directly below the bladder), inflates and then fills with water, during which time the patient will likely feel some pressure. The temperature-controlled water then circulates through the insulated shaft into the treatment balloon. The catheter conducts heat through the insulated shaft to the prostate gland, raises the temperature of the gland, and then destroys the obstructive tissue to a depth of approximately 11 mm. Throughout the procedure, the computer console precisely maintains the temperature of the water at 60° C. After 45 minutes of treatment, the catheter is removed. Over the next few weeks, the body either sloughs off or absorbs the destroyed tissues. Following the procedure, the patient will likely experience swelling. A urethral catheter will ease the constricted flow of urine caused by the swelling. The catheter will remain in place for approximately 4 to 17 days, or until the swelling is reduced and normal urinary flow is restored. Patients also experience transient hematuria, or temporary blood in the urine, after the procedure. Studies indicate that some patients experienced treatable urinary tract infection or urinary urgency after the procedure.
