[Minimal invasive therapy of benign prostatic hyperplasia].
Within the past decade, a number of minimally invasive treatment alternatives to transurethral resection of the prostate (TUR/P) have been developed. The majority of these techniques make use of the therapeutic effect of heat with a close correlation of therapeutic heat and clinical efficacy, yet also postoperative morbidity. Therapeutic temperatures below 45 to 47 degrees C ("hyperthermia") do not induce irreversible tissue destruction and are therefore obsolet. Temperatures in the range of 47 and 60 degrees C ("thermotherapy") lead to irreversible tissue destruction. Between 60 and 200 degrees C ("thermoablation") cystic cavities, comparable to post-TUR/P effects, can be seen. Even higher temperatures lead to tissue vaporisation and are used for laser-prostatectomy and electrovaporisation of the prostate. Although randomised phase-III clinical trials are available for some of these techniques, it is too early to make a definitive judgement concerning their future role in the armentarium for BPH-treatment. Finally, it needs to be emphasized that the golden standard for BPH-therapy is TUR/P.