Madersbacher S, Marberger M
Universitätsklinik für Urologie, Wien.
Wien Med Wochenschr. 1996;146(8):169-75.
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.
在过去十年中，已经开发出了多种经尿道前列腺切除术（TUR/P）的微创治疗替代方法。这些技术大多利用热的治疗效果，治疗热与临床疗效密切相关，但也与术后发病率相关。低于45至47摄氏度的治疗温度（“热疗”）不会导致不可逆的组织破坏，因此已过时。47至60摄氏度范围内的温度（“温热疗法”）会导致不可逆的组织破坏。在60至200摄氏度之间（“热消融”），可以看到与TUR/P术后效果相当的囊性腔隙。更高的温度会导致组织汽化，用于激光前列腺切除术和前列腺电汽化术。尽管其中一些技术有随机III期临床试验，但现在就对它们在良性前列腺增生症（BPH）治疗手段中的未来作用做出明确判断还为时过早。最后，需要强调的是，BPH治疗 的金标准是TUR/P。
