Transurethral needle ablation (TUNA) is used to treat an
enlarged prostate gland (benign prostatic hyperplasia, or BPH)
with a needle-shaped device that delivers heat to very precise areas of the
prostate. The device is inserted up the
urethra inside a tube (catheter) that protects other
tissues from being burned. The heat destroys specific areas that are blocking
the flow of urine out of the bladder. This relieves BPH symptoms. The procedure
does not require an overnight stay in the hospital.
A year after TUNA surgery, symptoms can be about 13 points lower on the International Prostate Symptom Score (IPSS). For most men, that means a 60% reduction in symptoms. For example, if your symptom score is 25 (severe), it could be reduced to about 10 (moderate). With transurethral resection of the prostate (TURP), symptoms can be reduced by about 85% in most men.1 But TUNA is less likely than TURP to cause complications.
has minimal complications. The two most common are an inability to urinate
(urinary retention) in the first 24 hours after surgery and pain while
urinating. Sexual ability is generally not affected.2
The main advantages of this treatment
The main disadvantages of this treatment are:
Reports have warned that in a small number of cases TUNA has caused serious injuries and complications,
including damage to the penis and urethra. Injuries have required urostomies, partial amputation of the penis, and
other procedures. In December 2000, the U.S. Food and Drug Administration (FDA) issued a warning about these
Fitzpatrick JM (2007). Minimally invasive and
endoscopic management of benign prostatic hyperplasia. In AJ Wein, ed.,
Campbell-Walsh Urology, 9th ed., vol. 3. pp. 2803–2844.
Philadelphia: Saunders Elsevier.
AUA Practice Guidelines Committee (2003). AUA
guideline on management of benign prostatic hyperplasia (2003). Chapter 1:
Diagnosis and treatment recommendations. Journal of Urology, 170(2, Part 1): 530–547. Available online: http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines.cfm?sub=bph.
Lourenco T, et al. (2008). Minimally invasive treatments for benign prostatic enlargement: Systematic review of randomised controlled trials. BMJ, 337(7676): a1662–a1669.
May 3, 2012
E. Gregory Thompson, MD - Internal Medicine
& Anne C. Poinier, MD - Internal Medicine & J. Curtis Nickel, MD, FRCSC - Urology
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