CURRENT STATUS OF TRANSURETHRAL THERMOTHERAPY AT THE MAYO-CLINIC

With the ever-expanding elderly population in the United States, benig n prostatic hyperplasia (BPH) has become a widespread condition. Altho ugh surgical intervention (open prostatectomy and transurethral resect ion of the prostate) was the typical management approach for BPH in th e past, other options currently include drug therapy and transurethral thermotherapy, a minimally invasive procedure that involves the targe ting of heat deep within the prostate transition zone while cooling th e surrounding anatomic structures with circulating water. Two thermoth erapy devices-the Prostatron and the T3 transurethral thermoablation t herapy catheter-have been studied in randomized, controlled clinical t rials at the Mayo Clinic. Both devices were shown to be effective in a substantial subset of patients with BPH: symptom scores decreased, pe ak urinary now rates increased, and total serum prostate-specific anti gen levels increased, an indication of destruction of adenomatous tiss ue. All patients were able to complete the treatment without the need for general or regional anesthesia, and thermotherapy was associated w ith few postprocedural events. Although this therapeutic strategy is c urrently used selectively in patients with lateral lobe prostatic aden oma, improvements in technology and understanding of the thermoregulat ory properties of the prostate should broaden the application of therm otherapy devices in the management of BPH.