Evaluation and comparison of five experimental BPH/prostate cancer treatment modalities

Five non-pharmacological, experimental, prostate (benign hyperplasia/cancer) treatment modalities including transurethral radiofrequency thermotherapy (TURT); transurethral microwave thermotherapy (TUMT); transurethral and transrectal microwave thermotherapy (TUMT/TRMT); interstitial laser coagulation (ILC); and interstitial cryotherapy (IC), are evaluated. These and other similar techniques are currently in various stages of development and clinical use. Most of these modalities produce relatively similar effects in tissue; however, each has pathophysiologic features and potential complications which may preference its use in a specific anatomical and/or disease situation. All treatments were performed using the canine prostate model, by the same investigators. Our studies have shown that although the canine prostate does not respond to injury exactly as the human prostate does, the effects are similar enough to be conceptually, and often specifically, valuable from efficacy and safety standpoints. Two of the five treatments evaluated (TURT, TUMT/TRMT) resulted in marked dilation of the prostatic urethra without significant parenchymal effect. Three of the treatments (IC, ILC, TUMT) resulted in parenchymal ablation with only minor dilation of the urethra. Although each technique has encouraging experimental findings, ultimate success will be determined by further definition of the instrumentation technique and appropriate clinical implementation.