CoreTherm Treatment

CoreTherm is performed as an outpatient treatment within a 45-minute visit. The actual treatment with energy being delivered is performed within 6-15 minutes and the patient can normally go home directly after the procedure is concluded. No general anesthesia or hospitalization is required.

Step 1

Pretreatment

CoreBloc Intraprostatic Injection

  • Anesthesia reaches perfect location regardless of prostate size.
  • Shortens treatment time to 6-15 minutes.
  • Reduces energy requirement by 80%.
step1

Step 2

Treatment

Real-time ”Cell-kill” calculation with patented feedback system

  • Measures intra-prostatic temperature.
  • Cooled to prevent heating.
  • Calculates cell-kill to achieve 20% volume.
step2

Step 3

Post Treatment

Effective long-term symptom relief

  • 90% responders according to DeWildt criteria
  • 50% improvement concerning IPSS, PVL och Qmax
  • Prostate volume reduced by 30%
step3
Step 1: Core Bloc intraprostatic injection

Before the actual microwave treatment starts, intraprostatic injections of local anesthetics are administered in all four quadrants of the gland using the Core Bloc® technique. Increased hydrostatic pressure from the injected volume inside the prostate capsule will compress the blood vessels, ensuring effective analgesia and minimizing intraprostatic blood flow. The Core Bloc injection needle is introduced through the treatment catheter and will reach the perfect location in the base area of the prostate irrespective of prostate size. These injections represent a tremendous difference and improvement over traditional TUMT technologies, ensuring a relatively pain-free treatment and significantly reducing treatment time to approximately 10 minutes (compared to one hour before). The total energy needed is also reduced by 80%, an important consideration for treatment safety.

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Intraprostatic injection with Core Bloc.
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4 quadrants of the gland where local anaestetic take place.

 

Step 2: Real-time “cell-kill” calculation with patented feedback system

ct_redIntraprostatic temperature measurement in three spots.

The CoreTherm treatment catheter contains several functions. The catheter contains a helicoid microwave-antenna delivering high energy to the prostatic tissue. It also harbors an intra-prostatic temperature probe (IP sensor) measuring the intraprostate temperature in three defined spots during treatment. The treatment catheter is also cooled to prevent heating of the urethra during the procedure by continuous water circulation driven by an exterior pump.

The treatment endpoint is to destroy approximately 20% of the baseline prostate volume surrounding the urethra. The shrinking of the enlarged prostate around the urethra mimics the cone shaped cavity after TURP. This coagulation necrosis is achieved by raising the temperature to approximately 55 degrees Celsius in the treatment area of the prostate. The body will resorb most of the dead tissue, but some part may be discharged during the recovery period.

A real-time “cell-kill” calculation is made possible using a patented feedback system. By continuously monitoring real temperatures at three different distances inside the prostate, it is possible for the software to calculate the actual temperature spread in the whole of the prostate gland. Using an algorithm, the feedback system can also calculate the accumulated amount of tissue necrosis in real-time. When you have achieved the target volume, the treatment is complete – ensuring a high level of customization for each individual patient.

Step 3:  Effective long-term symptom relief equivalent to surgical alternatives

Because of the dramatic reduction in the size of the prostate, there is a natural healing period after the treatment while the body recovers and swelling subsides. This recovery period generally lasts 8-12 weeks, similar to the recovery period required with a TURP surgical procedure. During the first two weeks of this recovery period, patients will require antibiotics and a temporary catheter to ensure proper urination and help prevent infection. Patients report this is a minor inconvenience and worth the long-term benefits. At three months check-up, most symptoms are gone and objective improvements are obvious. Responders according to deWildt criteria are 80 – 90% with simultaneous improvements concerning Qmax, PVR, IPSS are > 50% and prostate volumes are reduced nearly 30%.

Will the patient feel discomfort after the procedure?

While some patients experience no discomfort after therapy, others may experience urinary urgency due to swelling and irritation of the prostate but these symptoms will gradually disappear. Some patients consider urinary urgency to be a problem, especially during the first few days after therapy. Such problems gradually disappear as the swelling goes down and then resolve completely.

Can the patient go home direct after the procedure?

The procedure itself takes about 6-15 minutes and you can usually discharge the patient a few hours later.

Does the patient need any other medication following therapy?

Some patients may require analgesia for a few days following the procedure. Discuss such needs with your patient. No long-term medication is needed after CoreTherm therapy.

How effective is CoreTherm compared with surgery?

Scientific studies show that CoreTherm is as effective as surgery (TURP). CoreTherm is associated with fewer risks and is easier on the patient. The procedure can be carried out in an outpatient setting, and no hospitalization or general anesthesia is required.

CoreTherm Treatment vs TURP for clinical BPH:
A prospective randomized multicenter study with 5 years Follow-up.

CoreTherm IPSS CoreTherm TURP

Control TRUS 3 months after: Volym 25, 4cc
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Summery:

  • Patient born 1944 diagnosed BPH
  • Prostate size before treatment 36cc
  • CoreTherm treatment time: 6 min
  • Control TRUS 3 months after: Volym 25, 4cc