How do transurethral needle ablation of the prostate and transurethral microwave thermotherapy compare with transurethral prostatectomy?

Throughout the past decade, several minimally invasive therapies for benign prostatic hyperplasia (BPH) have emerged to challenge transurethral prostatectomy (TURP) in efficacy and safety. This review compares high- and lowenergy transurethral microwave thermotherapy (TUMT) and transurethral needle ablation (TUNA) of the prostate with TURP in clinical efficacy and safety. In reducing benign prostatic hyperplasia (BPH) symptoms, TUNA and TUMT are, at best, equal to TURP. However, the effects of TUMT and TUNA on objective measures of obstructive uropathy are minimal and less durable compared with TURP. The sole determinant of when and how to treat a patient with BPH is not solely a therapy’s clinical effectiveness. Other multiple factors must be considered, including safety, adverse effects, sexual function, and cost. The role of TUNA and TUMT lies in offering a cost-effective alternative for achieving substantial improvement in quality of life at an acceptable risk level for treatment-associated complications.