Water-Induced Thermotherapy for Prostatitis
What Is Water Induced Thermotherapy?
Water-induced thermotherapy is considered an alternative treatment for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). This therapy uses hot water, and has been used to treat benign prostatic hyperplasia (BPH), which is also called enlarged prostate. While BPH and prostatitis are different conditions, they can have some similar symptoms, especially urinary symptoms.
The treatment takes just one 45-minute visit to the urologist. This minimally invasive treatment is easily administered in an outpatient setting. It does not require formal anesthesia, but you should discuss pain control with your doctor before the procedure.
The prostate gland lies between a man’s bladder and penis, and it surrounds the urethra, which carries urine out of the body. To perform the water-induced thermotherapy procedure, the doctor inserts a soft, pliable catheter through the penis up to the prostate gland and fills it with water. A system circulates the hot water for 45 minutes. The hot water heats the prostate tissue.
When treating BPH the water temperature is between 60 and 62 degrees Celsius (ºC), but when treating prostatitis, the water is cooler and between 40 to 47ºC, making water-induced thermotherapy for prostatitis a safe, nondestructive procedure for prostatitis patients.
Does Water-Induced Thermotherapy for Prostatitis Work?
A 2001 study on water-induced thermotherapy for prostatitis involved 30 patients with CPPS who ranged from 24 to 63 years old. The men were treated with water-induced thermotherapy. Study participants completed their NIH Prostatitis Symptom Score (PSS) and underwent uroflowmetry at baseline, 1, 6, and 12 months following treatment. All study participants were treated at 47ºC in a single 45-minute session, the utilized topical anesthetic gel.
There were improvements in the NIH Chronic Pain Symptom Index (CPSI), pain scores, urinary symptom scores, and quality of life scores. Overall, the NIH CPSI score improved by 55% at 12 months, and similar responses were noted in pain scores (57.6%), urinary symptom scores (45.9%), and quality of life scores (50%). Peak flow rates and average flow rates remained constant during the follow-up period. (+/- 1 ml/sec), indicating that the treatment did not negatively affect the patients’ urine flow.
The most significant predictor of change was the degree of symptom severity at baseline; with higher baseline scores reporting greater symptom improvement. Men who had moderate to severe symptoms represented the majority of patients at baseline. In the three follow-up appointments, the number of patients with severe symptoms constantly decreased, the majority rating their symptoms as mild, with a few reporting moderate symptom scores.
Researchers concluded that water-induced thermotherapy is a minimally invasive, well-tolerated procedure. Water-induced thermotherapy for prostatitis is an affordable, durable, and viable option for the treatment of CP/CPPS. Since no necrosis is produced at this lower treatment temperature, there is no need for post-treatment catheterization.
Other Heat Treatments
Other drug-free treatments that involve heat include sitz baths and heat therapy. Heat therapy involves applying local heat via a heating pad or hot-water bottle to the perineal area to relieve pain. Heat helps CP/CPPS sufferers by increasing blood flow to the area. Some men find relief from using ice packs for prostatitis instead of heat.
More involved heat therapies, also called hyperthermia, include transurethral microwave hyperthermia and transurethral microwave thermotherapy (TUMT). These therapies increase the temperature of the prostate to relieve symptoms. They are more invasive and are considered a last resort treatment.
Reference for Water Induced Thermotherapy for Prostatitis:
Muschter, Rolf, et al. Transurethral water-induced thermotherapy for the treatment of benign prostatic hyperplasia: a prospective multicenter clinical trial. The Journal of Urology. Volume 164, Issue 5, November 2000, Pages 1565–1569
Guercini, Federico M., et al. Water induced thermotherapy (wit) for the treatment of chronic pelvic pain syndrome (cpps) – a multi-centre feasibility study. AUA annual Meeting 2002 in Orlando, FL.