Patient Instructions for Transurethral Microwave Thermotherapy Thermatrx Treatment

Your appointment is scheduled in our office

on _______________ at ____________ with Dr. ___________________.

Please follow the directions below. Please call if you have any questions, or if for any reason you will be unable to make your appointment.

1. Reduce the amount of alcoholic and caffeinated beverages and tobacco products 48 hours prior to the treatment.
2. Limit your intake of fluids the day of the treatment.
3. Be sure to eat something the day of the treatment.
4. Fleets enema should be given 2 hours prior to treatment.
5. Please make arrangements for transportation to and from the treatment.
6. You may bring books, magazines, or your favorite music to pass the time.
7. If your physician prescribes medication to you, please follow instructions carefully.
8. You may take all your daily medications unless otherwise indicated by your physician.
9. Wear comfortable or loose fitting clothing the day of the treatment. A catheter will be placed in your bladder and stay there for the next few days. Your doctor will instruct you on how and when the catheter will be removed.

Instructions for Medications Pre-TUMT

Two Hours Before Treatment:
      Fleets Enema- Use as directed.

One Hour Before Treatment Take One of Each of the Following:
      Motrin 800 mg
      Ditropan 5 mg
      Valium 10 mg
      Cipro 500 mg

Patient Consent Form

Thermatrx Microwave Thermotherapy Treatment for Benign Prostatic Hyperplasia

 I, ___________________________________, hereby authorize Dr. _________________ to perform the Thermatrx Microwave Thermotherapy for the treatment of Benign Prostatic Hyperplasia. This treatment will be performed on ____________________________. I understand that during the treatment a catheter-like tube will be inserted into my urethra using anesthetic jelly. There will also be a small probe inserted into my rectum. These probes will be connected to the microwave generator. This treatment has been used investigationally since 1988 and received FDA approval in 2001.

The benefit of this treatment is relief of my bladder outflow obstruction. I understand the possibility of risks associated with transurethral microwave thermotherapy. Some of the risks include blood in my urine, small amounts of blood in the sperm, temporary inability to urinate, frequent urination, urgency, discomfort in the bladder or rectum, and a burning sensation during urination. I understand these will be short-term side effects and should subside in a few days. Additionally, other possible side effects that were not noticed in the clinical study include a loss of sexual functioning, sterility, heat damage to tissue.

My physician has explained alternative methods for the treatment of benign prostatic hyperplasia. Alternatives include watchful waiting, drug therapy, surgical procedures such as transurethral resection of the prostate, open prostatectomy, and other heat therapies. My physician has discussed these alternatives with me and feels that microwave thermotherapy is the best treatment for my particular condition. The doctor has answered all my questions regarding this treatment, and I agree to proceed with the TherMatrx Microwave Thermotherapy treatment.

My signature below indicates that I have read and understand this consent form.

SIGNED__________________________________

DATE____________________________________

WITNESS_________________________________

This web site is intended as an educational resource for physicians, patients, and the community and provides only an overview of The Urology Clinic and Georgia Lithotripsy & Laser Center, select urologic conditions and procedures. It is not intended to serve as or replace an evaluation by a health care provider. Patients with urologic complaints should be seen and evaluated individually so that their unique situation can be addressed appropriately.
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The Urology Clinic
120 Trinity Place
Athens, GA 30607
(706) 543-2718 (T)
(706) 353-3709 (F)

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Monday-Friday

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461 Cook Street, Suite D
Joe A Adams Building
Royston, GA 30662
(706) 543-2718 (T)
(706) 353-3709 (F)

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