Hyperthermia applied to the prostate for the treatment of benign prostatic hyperplasia (BPH) is now being used after its earlier encouraging application in prostatic cancer. Most of the pioneering work was carried out by our group using 915 MHz microwaves, delivered through a transrectal probe, in the 41–44°C range, using the Prostathermer. Objective and subjective improvement in obstructive and irritative symptoms has been reported in 40–60% of the cases. Evidence indicates that this is definitely not a placebo effect. Other recently introduced machines use either the transrectal or the transurethral approach and induce higher temperatures (45–48°C) in the prostate. Because the groups were not sufficiently large or comparable and there was no prolonged follow up, we cannot at the moment draw meaningful conclusions in comparing the new generation of machines with each other or with our original technology. More time is needed to establish the optimum temperature in hyperthermia for BPH, the best and safest route to achieve this objective (whether transrectal or transurethral), how long each treatment should last, which patients should receive it, and how best they should be selected and followed. Hyperthermia has been shown to have a definite place in the non-surgical treatment of BPH. At present it may be offered in particular to those unwilling to undergo or unsuitable for operation.
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