[Minimal invasive therapy of benign prostatic hyperplasia]

Area of Science:

• Urology
• Minimally Invasive Surgery
• Thermal Medicine

Background:

• Benign prostatic hyperplasia (BPH) is a common condition in aging men.
• Transurethral resection of the prostate (TUR/P) is the current gold standard for BPH treatment.
• Minimally invasive therapies offer alternatives to TUR/P, often utilizing heat.

Purpose of the Study:

• To review and compare various minimally invasive, heat-based treatment alternatives for BPH.
• To evaluate the correlation between therapeutic heat levels, clinical efficacy, and postoperative morbidity.
• To discuss the current and future role of these techniques in BPH management.

Main Methods:

• Review of existing literature on heat-based BPH treatments.
• Categorization of techniques based on temperature ranges (hyperthermia, thermotherapy, thermoablation, vaporization).
• Analysis of clinical efficacy and morbidity data, including available phase-III trials.

Main Results:

• Different temperature ranges induce varying degrees of tissue destruction, from hyperthermia (non-destructive) to vaporization (ablative).
• Thermotherapy (47-60°C) and thermoablation (>60°C) cause irreversible tissue destruction and cavity formation.
• Close correlation observed between therapeutic heat intensity, efficacy, and postoperative morbidity.

Conclusions:

• Minimally invasive heat therapies show potential for BPH treatment, with outcomes varying by temperature.
• While some techniques have phase-III trial data, definitive conclusions on their long-term role are pending.
• Transurethral resection of the prostate (TUR/P) remains the established gold standard for BPH therapy.