[Thermotherapy of benign prostatic hyperplasia].

Transurethral microwave thermotherapy (TUMT) differs from hyperthermia in the higher intraprostatic temperatures reached and in the irreversible damage it causes to intraprostatic tissue. Both subjective symptoms and objective data, such as peak flow and residual urine, are influenced differently by TUMT and by sham treatment. As expected, no improvement of the objective data was documented with TUMT, in contrast to transurethral resection of the prostate (TURP), whereas the improvement in subjective symptoms was comparable. The complication rate in terms of morbidity is clearly lower with TUMT than with TURP. TUMT can be performed as an outpatient procedure without a general anaesthetic. TUMT had a specific effect on outflow obstruction, but it was less pronounced than that achieved with TURP. Therefore, TUMT is indicated for patients with typical symptoms of BPH and a mild mechanical obstruction. In this patient group TUMT seems to be the optimal treatment, whereas TURP would constitute "overtreatment" owing to its higher complication rate and the unnecessary tissue resection. At this stage of BPH, TURP is justifiable only with reservations; it should be reserved for BPH with moderate and severe mechanical obstruction.