A number of less-invasive treatments have been developed for the treatment of BPH. Many of the treatments that have been developed involve the ablation of obstructive prostatic tissue using heat. The destroyed (heat damaged) tissue either sloughs out of the body with the urine or is reabsorbed and carried away through the lymphatic system. More recently less-invasive laser treatments have been developed which actually remove the tissue through either vaporization or resection and these treatments will be discussed later.
The ablative modalities that have been the most successful include those that rely on radiofrequency energy, microwave energy and laser light energy that heat prostatic tissue to temperatures in excess of 45-degrees Celsius thereby creating a coagulative necrosis of the tissue.
Microwave energy is used in a procedure referred to as Transurethral Microwave Therapy (TUMT). A number of companies manufacture TUMT devices each with their own proprietary advantages. TUMT has been shown to be able to reduce urinary symptom scores 65% (vs. 77% for TURP). Peak flow rates are increased 70% (vs. 119% with TURP). Although TUMT does not reach the same levels of clinical improvement as TURP it has a more favorable complication profile. Retrograte ejaculation is 22.2% (vs. 57.6% with TURP), the transfusion rate with TUMT is 0% (vs. 5.7% with TURP). Stricture is also more common with TURP
Radiofrequency energy can also be used to ablate obstructive prostatic tissue. A technique originally termed TransUrethral Needle Ablation (TUNA) has been in use. The TUNA system has proven to reduce the rate of complications compared with traditional TURP but also results in a higher rate of retreatment (over 7x). This treatment is delivered by two radio antenna (needles) that are inserted into the lobes of the prostate according to calculations made based on the prostate’s length. The RF energy ablates (heats to the point of a coagulative necrosis) the tissue. The dead tissue then later sloughs out in the urine.
 RM Hoffman et al., BJU Int. 2004 Nov;94(7):1031-6
 Bouza et al. BMC Urol. 2006 Jun 21;6:14.