PROSTATE-RECTUM-FISTULA FOLLOWING TRANSRE CTAL HYPERTHERMIA FOR BENIGN PROSTATIC HYPERPLASIA OF A HIGH-RISK PATIENT

A 74-year-old patient with benign prostatic hyperplasia was subjected to 10 one-hour-sessions of transrectal hyperthermia at his own request because of cardiac risk factors. 6 weeks postoperatively a prostate-r ectum-fistula developed resulting in a transperineal excision and clos ure of the fistula. Because of a perineal feces/urine fistula a sigmoi d colostomy became necessary. 5 month postoperatively the sigmoid colo stomy could be rediverted following suprapubic urinary diversion for s everal weeks and a TUR of the prostate in the meantime. The case repor t shows that transrectal hyperthermia for BPH should be declared as ob solete, not only because an objective effect is lacking, but also beca use of rare but severe side effects. The present studies of hypertherm ia and thermotherapia are discussed.