TUMT (Transurethral Microwave Thermotherapy)
An option for benign prostate enlargement in which microwave energy delivered through the urinary passage heats and shrinks prostate tissue, without an operating theatre or general anaesthesia.
Last medically reviewed: October 6, 2026 — Assoc. Prof. Dr. Müslüm Ergün
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- Procedure time
- 30–60 minutes
- Anesthesia
- Local anaesthesia, with light sedation if needed
- Hospital stay
- Day case
- Stay in Türkiye
- 5–8 days
- Catheter duration
- 3–7 days
- Return to work
- 2–5 days
- Flight clearance
- After catheter removal and review
About the condition
Benign prostatic hyperplasia (BPH) is enlargement of the prostate with age, compressing the urinary channel from outside. A weak stream, hesitancy, frequency and waking at night are the commonest symptoms.
In TUMT, microwave energy is delivered to the prostate through a special catheter placed along the urinary passage, heating the tissue. The heat creates controlled damage in the obstructing tissue; it shrinks over weeks and the pressure on the channel falls. A cooling system protects the urethra and surrounding tissue during the procedure.
THE DEFINING FEATURE OF THIS METHOD is that it needs neither an operating theatre nor general anaesthesia. It can be carried out as a day case under local anaesthesia with light sedation if required. It therefore stands out as an option for men at high anaesthetic risk because of heart or lung disease.
THE EFFECT DOES NOT BEGIN IMMEDIATELY. Because the tissue shrinks with heat, real improvement settles over weeks, and a temporary WORSENING of symptoms in the first weeks is usual. That does not mean the procedure has failed. For a man expecting immediate relief, TUMT is not the right option — and that is said plainly beforehand.
NO TISSUE IS REMOVED, SO THERE IS NO PATHOLOGY. In TURP and enucleation the tissue removed goes to pathology and an unexpected focus of cancer can be caught. With TUMT no such examination is possible. Assessment for cancer with PSA and examination is therefore carried out separately and carefully beforehand.
THE CHANCE OF A FURTHER PROCEDURE IS HIGHER. Because the tissue is not fully removed, symptoms returning over the years and a second procedure (TURP, enucleation or medication) becoming necessary are more likely than with tissue-removing methods. If you are travelling from abroad, build that possibility into your plans as a second journey.
IT STANDS OUT FOR PRESERVING EJACULATION. Retrograde ejaculation (semen passing into the bladder), common after tissue-removing methods, is less expected after TUMT. If sexual function and ejaculation are your priority, say so plainly; the options are ordered accordingly.
Who is it suitable for?
May be suitable
- Men with a small to moderate prostate who gain insufficient benefit from medication
- Men at high anaesthetic risk, in whom theatre conditions should be avoided
- Men who state preserving ejaculation as a priority
- Men who accept improvement arriving over weeks rather than at once
- Selected men on anticoagulants in whom a bleeding procedure is to be avoided — medication is still managed individually
May not be suitable
- Men with a very large prostate
- Men catheterised because of retention who need a rapid result
- Men with bladder stones or recurrent significant bleeding — a tissue-removing method is needed
- Men in whom suspicion of prostate cancer is unresolved: diagnostic assessment is completed first
- Men with untreated urinary infection
- Selected men with a prominent middle lobe, in whom the expected benefit may be limited
- Men with a hip prosthesis or pelvic metal implant, in whom suitability is assessed separately
Technology used
- Transurethral microwave catheter with a cooling system
- Ultrasound determination of prostate volume
- Uroflowmetry and post-void residual measurement
- PSA and digital rectal examination — to assess cancer separately
- Cystoscopy where needed — to assess the middle lobe and the bladder
- Temporary catheter after the procedure
Surgeon's experience
Verifiable information
- Surgeon's experience
- Assoc. Prof. Dr. Müslüm Ergün121270
Step-by-step journey
- Remotely
Initial assessment
Imaging showing prostate volume, uroflowmetry and residual urine, your PSA, your medication (particularly anticoagulants), your heart and lung conditions and any pelvic metal implants are reviewed.
- Day 1
Examination and tests
Examination, uroflowmetry, residual volume, urinalysis and culture. If the culture grows an organism the procedure is postponed. Cystoscopy assesses the middle lobe where needed.
- Day 2
Procedure
Under local anaesthesia, with light sedation if required, the treatment catheter is placed along the urinary passage and microwave energy is delivered. A temporary catheter is left at the end. You go home the same day.
- Days 3–7
Catheter removal
The catheter is removed here and the first void observed, so that difficulty passing urine is dealt with close to the hospital. The return flight is not planned for the day after removal.
- Weeks 2–6
The effect settles
Real improvement becomes apparent in this period. Frequency and stinging are usual in the first weeks; this is a temporary phase.
- Month 3
Assessment of the result
Repeat uroflowmetry and residual volume measure the result. Those measurements are the objective counterpart of how far the symptoms have improved.
Method comparison
| Criterion | TUMT (microwave) | TURP | ThuLEP (enucleation) |
|---|---|---|---|
| What happens to the tissue | Left in place, shrinks with heat | Partially shaved away | Removed completely |
| Anaesthesia | Local, with sedation if needed | General or spinal | General or spinal |
| Operating theatre needed | No | Yes | Yes |
| When the benefit starts | Over weeks | Immediately | Immediately |
| Prostate size limit | Small to moderate | Small to moderate | No practical ceiling |
| Ejaculation preserved | More often preserved | Less likely | Less likely |
| Chance of a further procedure | Higher | Intermediate | Lower |
| Tissue available for pathology | No tissue is removed | Yes, it is examined | Yes, it is examined |
| Hospital stay | Day case | 1–2 nights | 1 night |
The right question is not "which is more advanced" but "what is my priority". If avoiding anaesthetic risk and preserving ejaculation come first, TUMT stands out; if a definitive and lasting solution to the urinary symptoms comes first, enucleation does. If you are travelling from abroad, weigh the possibility of a second journey in that decision.
Risks
- DELAYED ONSET AND WORSENING OF SYMPTOMS IN THE FIRST WEEKS: an expected course, but a serious disappointment for a man expecting immediate relief. That is why it is discussed from the outset
- A LONGER PERIOD WITH A CATHETER: swelling caused by the heat means the catheter stays for several days; in some men that lasts longer, or the catheter has to be replaced temporarily after removal
- Urinary tract infection
- Stinging, frequency and urgency — expected in the first weeks
- Blood in the urine — usually slight and temporary
- THE NEED FOR A FURTHER PROCEDURE: because the tissue is not fully removed, a second procedure over the years is more likely than after tissue-removing methods
- NO PATHOLOGY IS POSSIBLE: because no tissue is removed, an unexpected focus of cancer cannot be caught this way
- Rarely, narrowing of the urinary channel
Alternatives
- Observation and lifestyle measures — for mild symptoms: reducing evening fluids, limiting caffeine and alcohol, treating constipation
- Alpha blockers — improve the stream relatively quickly; can cause dizziness and changes in ejaculation
- 5-alpha reductase inhibitors — shrink the prostate over months; remember they roughly halve the PSA value
- Rezūm (water vapour) — like TUMT, heat-based and minimally invasive; the benefit is again delayed
- Prostatic urethral lift (UroLift) — no tissue removed, suitable for selected anatomy
- TURP — established endoscopic resection; tissue is removed and pathology is possible
- ThuLEP / HoLEP — enucleation; no practical ceiling on prostate size and a lower chance of a further procedure
- Prostatic artery embolisation — an interventional radiology option in selected patients
Recovery
First 48 hours
The catheter is in place. Slight blood in the urine is usual. Drink plenty. Fever, or no urine draining from the catheter, requires immediate contact.
After catheter removal
Frequency, urgency and stinging are usual. A small number of men need the catheter replaced temporarily; for that reason no flight is planned for the day after removal.
Weeks 2–4
A temporary worsening of symptoms can occur in this period and does not mean failure. Return to normal activity is usually within a few days.
Months 1–3
Real improvement settles in this period. A clear change in the stream and in waking at night is expected.
Long term
If symptoms return, the cause is investigated; not every recurrence comes from the prostate. A tissue-removing method is used where needed.
Frequently asked questions
Will I feel better straight after the procedure?
No. Because the tissue shrinks with heat, real improvement settles over weeks, and a temporary worsening in the first weeks is usual. If you are expecting immediate relief, TUMT is not the right option for you — let us discuss that from the start.
So I will not have a general anaesthetic?
TUMT is usually carried out under local anaesthesia with light sedation if required, and theatre conditions are not needed. That is the method’s clearest practical advantage, and it matters particularly in men at high anaesthetic risk.
Will my ejaculation be affected?
Retrograde ejaculation, common after tissue-removing methods, is less expected after TUMT. If sexual function and ejaculation are a priority for you, say so plainly; the options are ordered accordingly.
How long does the catheter stay?
Usually a few days; swelling caused by the heat can extend that. The catheter is removed here, so that any difficulty passing urine is dealt with close to the hospital. Do not plan your flight for the day after removal.
Will I need surgery again later?
Because the tissue is not fully removed, a second procedure over the years is more likely than after tissue-removing methods. If you are travelling from abroad, build that into your plans as a second journey.
Does the removed tissue go to pathology?
No. No tissue is removed in TUMT, so pathological examination is not possible. Assessment for cancer with PSA and examination is therefore carried out separately and carefully beforehand. Where there is a suspicion, diagnostic assessment is completed first.
My prostate is large — is this suitable for me?
TUMT comes to the fore in small and moderate prostates. In a very large prostate the expected benefit is limited and enucleation (ThuLEP) is more appropriate. Measuring the volume is the basis of that decision.
I take blood thinners — can it still be done?
TUMT is not a bleeding procedure and can be considered in such patients. Medication is nonetheless managed individually; do not stop your drug on your own initiative, and send the full list in advance.
I have a hip prosthesis — is that a problem?
Metal implants in the pelvis are assessed separately for suitability. Tell us the position and type of your prosthesis when you make contact.
How long should I stay in Türkiye?
Usually 5–8 days. Because catheter removal and the first review are done here, do not plan your return flight for the day after removal.
What documents should I send?
Imaging showing prostate volume, any uroflowmetry and post-void residual, a current PSA, a urinalysis, the full list of your medications, your heart and lung conditions, and details of any pelvic metal implant.
Articles on this topic
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This page is for general information only and is not a substitute for medical advice.
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