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New Technology To treat Prostatitis The Prostate Heat can be used for medical purposes …”Already at the beginning of the 19th century first clinical trials with systemically induced fever were performed on malignant tumors”….. Hyperthermia in cancer research. Historical development, current status of research, future perspectives and differentiation from alternative medical procedures. Issels R, Wadepohl M, Cramer H, Krieger K, Wilmanns W. Effect of temperature on living tissues Effects of temperature Normal Ramge Hyperthermia Termotherapy 33º C to 37º C 37º C to 43.5º C 45º C to 99º C COAGULATION Vaporization 100º C and more ABLATION Cell kill by heat Termotherapy :Efects of Temperature on tissues Temperature above 45º C produces Coagulative Necrosis Denaturization of proteins. Immediate cell kill Harnessing RF Waves for Treatment RF is a safe and effective treatment for many medical conditions, used routinely for surgical procedures. RF energy in contact with tissue will produce heating and therefore its coagulation or vaporization. Range used for medical applications is between 100kHz and 1200MHz RF Waves The Nervous system system operates at low Frequency Low Frequency signal cause : muscle contractions Pain Large Dose Cardiac Arrest Heating Methods T.U.M.T. Microwave (Cooled) T.U.M.T. Microwave Un-cooled W.I.T. Water Induced Thermotherapy T.U.R.F. AND T.U.N.A. Monopolar Radio Frequency TEMPRO Bipolar Radio Frequency Heat can be applied to PROSTATE by 2 technologies Microwaves : T.U.M.T. =Trans Urethral Microwave Thermotherapy Radiofrequency: T.U.R.F. =Trans Urethral Radio Frequency Non uniform distribution of energy using microwaves TUMT Uniform distribution of Radio Frequency heating Tempro Bi-Polar RF Thermotherapy The device that applies the Radio Frequency energy in Tempro The Applicator is a unique transurethral multi-polar electrode with conductive heating rings and temperature sensing elements (thermocouples) The applicator diameter is 16Fr. (about 5.5mm) Heating Rings Bladder Drainage Opening 3 Thermocouples Balloon for Applicator’s Positioning Functions of the Applicator Delivers RF energy from the controller to the prostate, producing tissue coagulation. Measures prostate temperature at 3 different locations. Allows urine to be drained during treatment. Testimonios Amstelland Hospital Holanda Amstelland Hospital Dept. of Urology Men’s Health Clinic Y. Reisman MD, PhD Laan vd Helende Meesters 8, 1186AM, Amstelveen, Noord-Holland, The Netherlands Telephone number: +31-(0)20- 3474747 I have started to use the Tempro system for BPH , but later on decided to use Tempro Thermal Therapy also for Chronical Prostatitis , which as we all know is very difficult to treat . The initial results with several of my patients are very positive and it appears to be a very helpful procedure “. Dr. Y. Reisman Age: 35 Chronic Abacterial Prostatitis from date: 04-01-2008 Previous treatments: NSAID, Ciproxin, Tamsulosine Symptoms: Perineal pain, sexual dysfunction, LUTS Tempro treatment date: October, 2008. Follow up: 12 month free of complains Testimonios The Institute for Thermotherapy- Alemania The Institute for Thermotherapy Dr. C. Beck Kleppingstrase 8, 44135 Dortmund Telephone: +49 231 14 12 88 Germany One of my patients could hardly stand up straight even though he was taking prescription drugs. After a Thermal Therapy treatment with Tempro Device he began to notice relief and he felt no pain at all."Dr. Christian Beck Age: 32 Chronic Abacterial Prostatitis from date: 15-10-2003 Previous treatments: NSAID, Ciproxin, Tamsulosine Symptoms: Perinea pain, sexual dysfunction, LUTS Tempro treatment date: January, 2009. Follow up: 9 month free of complains Testimonios Private Medical Clinic and Laboratory-Polonia Private Medical Clinic and Laboratory Dr Zenon Rudzki Kilinskiego St 78 Tel: + 48 34 365 1404 Czestochowa Poland “I have always thought Thermal Treatment may benefit my Prostatitis patients. Now that I have started to use the Tempro for Chronical Abacterial Prostatitis. I am surprised by the excellent results with some of the initial patients I have treated “. Dr. Z. Rudzki Age: 65 Chronic Abacterial Prostatitis from date: 03-10-1999 Previous treatments: NSAID, Ciproxin, Tamsulosine Symptoms: Pain in Testicles, Pubic area, Bladder, tip of Penis. Tempro treatment date: December, 2008. Follow up: 10 month free of pain or discomfort, Free urination TEMPRO Bipolar Radio Frequency Thermal Treatment FOR ABACTERIAL CHRONIC PROSTATITIS : Initial results Byun, Jae Sang MD, , Byoung Kyu Han MD, Kihyuck Moon MD Gangman Zaii urology Hospital. Nonhyeon-dong 164-2 Seoul Republic of Korea Table 1. Patients demographics Characteristics Value Numbers of the patients 41 Mean age (range) 42.6 ± 11.4 (28 – 72) Mean prostate size (cc) 25.3 ± 6.1 NIH classification (%) Category II 13 (31.8%) Category IIIA 14 (34.1%) Category IIIB 14 (34.1%) Table 2. Comparison of Chronic Prostatitis Symptom index scores between pretreatment (baseline) and TEMPRO after 3 months (post TEMPRO) CPSI score Baseline CPSI score Post-TEMPRO p CPSI score value Mean Total score 23.4 ± 7.3 16.5 ± 4.9 0.072 Mean pain domain score 11.2 ± 5.4 6.5 ± 3.8 0.034 Mean Urination domain score 5.7 ± 3.3 5.2 ± 2.3 0.872 Mean Quality of life domain score 6.6 ± 2.4 4.6 ± 1.6 0.138 Table 3. Subgroup analysis according to the decline of CPSI score more than 50 percent at 3 month after TEMPRO. Group A : CPSI scores decreased more than 50% after TEMPRO (= successful group) Group B : CPSI scores does not decreased more than 50% after TEMPRO (= unsuccessful group) Group A Group B 19 ( 46 % ) 22 ( 54 %) 50 or Younger than 50 years old 12 17 Older than 50 years old 7 5 Category II 8 5 Category IIIA 9 5 Category IIIB 2 12 Total Success p value Age group 0.638 NIH classification (%) 0.052 4.Conclusions These initial results look very positive with an overall success rate of 46 %. Perineal and/or perianal pain, as well as orchalgia, are substantially improved in the majority of the patients. Considering the complexity of the illness we consider it a simple and effective treatment. Side effects are minimal, therefore the Tempro treatment for prostatitis should be considered as a safe and effective one. We will continue to explore the potential of this treatment. Congreso Mundial de Endourologia WCE 2009 Munich Octubre 2009 Congreso Mundial de Endourologia WCE 2009 Munich Octubre 2009 Congreso Mundial de Endourologia WCE 2009 Munich Octubre 2009 Congreso Mundial de Endourologia WCE 2009 Munich Octubre 2009 Maneken Pis Thank you very much for your presence on this meeting Direx Group