Abstract
The future of conservative non-medical and minimally invasive management of benign prostatic hypertrophy (BPH) lies in the improvement in the technical possibilities of destroying prostatic tissue. After more than ®ve years' experimentation and experience with microwave thermotherapy, it is evident that this form of treatment will play an important role in the management of symptomatic BPH in the future. Patients will increasingly insist on less invasive treatment, especially when drug treatment fails. Apart from TUMT, other forms of destructive energy can be locally introduced into the prostate and such examples are laser therapy, radiofrequency treatment, high intensity focussed ultrasound (HIFU) and cryoablation. Basically, any form of energy can destroy malignant and benign tissue. The destruction itself is not the problem, the diculties lie in the surgical aspects of the equipment and machines developed for these purposes, and in particular in the exact and ecacious focusing of the energy by an acceptable route of administration.
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