Development of a rapidly computable descriptor of prostate tissue temperature during transurethral conductive heat therapy for benign prostate hyperplasia

Abstract

Benign prostate hyperplasia (BPH) is a condition in older men in which the mass of tissue in the prostate gland gradually increases over the course of many years, ultimately leading to urinary outflow obstruction. Current treatment of this condition is to surgically remove the obstructing tissue. One novel alternative therapy being studied is transurethral thermocoagulation of excessive prostatic mass. In this approach, a heat-emitting catheter is placed in the prostatic urethra, and the intraprostatic segment of the catheter is heated to temperatures above 60 degrees C for one hour. Two-dimensional cylindrical-co-ordinate computer simulations of this treatment modality were run to model resultant temperature distributions within the prostate gland and surrounding tissues. The simulations revealed that resultant tissue temperature changes were related directly to the power delivered to the catheter and inversely to the rate of blood perfusion. Further analysis of the temperature profiles produced a rapidly computable predictor of tissue temperature in the radial dimension. Using the predictor, a 'kill radius' around the prostatic urethra can be easily computed on-line, during treatment, from clinically available data, catheter power and catheter temperature. The computed kill radius may serve as a useful predictor of the extent of thermal devitalization of unwanted obstructing tissue and the long-term success of the treatment in relieving urinary outflow obstruction without surgery.