Transurethral Needle Ablation (TUNA): Effective treatment for benign prostatic hyperplasia. Using radio frequency to kill off prostate tissue and open up the urethra.
Transurethral needle ablation (TUNA) is a minimally invasive treatment for benign prostatic hyperplasia (BPH). This procedure uses low-level radiofrequency energy to heat and ablate prostate tissue, reducing prostate volume and alleviating symptoms associated with BPH. TUNA is designed to be performed as an outpatient therapy, allowing patients to receive treatment in a urologist’s office.
The TUNA procedure involves inserting a cystoscope through the urethra to reach the prostate. Interstitial radiofrequency needles are then placed into the lateral lobes of the prostate, causing heat-induced coagulation necrosis. This process hardens parts of the prostate tissue, which is subsequently absorbed by the body or passed through urine.
TUNA offers a less invasive alternative to traditional surgical methods for treating BPH. Long-term studies have shown promising results in terms of symptom relief and improved quality of life for patients suffering from urinary symptoms related to an enlarged prostate.
Key Takeaways
- TUNA is a minimally invasive outpatient procedure for treating BPH
- The treatment uses radiofrequency energy to reduce prostate volume
- Long-term studies indicate TUNA can effectively relieve BPH symptoms
Understanding TUNA
Transurethral needle ablation (TUNA) is a minimally invasive procedure for treating benign prostatic hyperplasia (BPH). It uses radiofrequency energy to reduce prostate tissue and alleviate urinary symptoms.
The TUNA Procedure
The TUNA procedure involves inserting a specialized catheter through the urethra into the prostate. This catheter contains tiny needles that deliver radiofrequency energy directly into the prostate tissue. The energy heats the tissue to approximately 110°C, causing controlled damage.
I know what you are thinking – controlled damage – probably still hurts though. Most patients say it is minimal discomfort.
As the tissue heals, it shrinks, reducing pressure on the urethra. This process can improve urine flow and decrease BPH symptoms. The procedure typically takes 30-60 minutes and is often performed under local anesthesia with sedation.
TUNA is generally well-tolerated, with minimal side effects. Patients may experience mild discomfort or urinary symptoms for a few days post-procedure. Most individuals can return to normal activities within 24-48 hours.
Indications and Patient Selection
TUNA is primarily indicated for men with moderate to severe lower urinary tract symptoms due to BPH. Ideal candidates typically have a prostate volume between 20-50 cc and an International Prostate Symptom Score (IPSS) greater than 13.
Patient selection criteria include:
- Age: Usually 50 years or older
- Prostate-specific antigen (PSA) levels: Normal for age
- Uroflowmetry: Maximum flow rate (Qmax) less than 12 mL/s
TUNA may be particularly suitable for patients who are poor candidates for more invasive surgeries or those who wish to avoid potential sexual side effects associated with other BPH treatments.
It’s important to note that TUNA is not recommended for patients with prostate cancer, urethral strictures, or neurogenic bladder disorders. A thorough evaluation, including cystoscopy and transrectal ultrasonography, is essential for proper patient selection.
Outcomes and Considerations
Transurethral needle ablation (TUNA) offers a range of outcomes for patients with benign prostatic hyperplasia. This minimally invasive procedure has shown promising results in clinical trials, but also comes with potential risks and considerations.
Effectiveness and Clinical Results
TUNA has demonstrated effectiveness in treating symptomatic benign prostatic hyperplasia. Clinical trials have shown improvements in International Prostate Symptom Scores and quality of life measures. Many patients experience reduced urinary symptoms and improved flow rates.
Long-term studies indicate that TUNA can provide sustained benefits. A 5-year follow-up study revealed stable treatment outcomes, suggesting TUNA as a viable option for men with lower urinary tract symptoms due to BPH.
Urologists have reported success rates varying between 50-70% in multicenter studies. However, results can differ based on factors such as prostate size and symptom severity.
Potential Risks and Complications
While TUNA is generally considered safe, it’s not without risks. Common side effects include:
- Temporary urinary retention (10-20% of cases)
- Hematuria (blood in urine)
- Urinary tract infections
More serious complications, though rare, can occur:
- Urethral stricture – (narrowing of the urethra due to scar tissue)
- Erectile dysfunction – (typically temporary)
- Retrograde ejaculation – (semen flows into the bladded instead of out of the body suring ejaculation)
Patients may experience discomfort or pain during and after the procedure. Most side effects resolve within a few weeks. The risk of severe complications is lower compared to more invasive treatments like transurethral resection of the prostate (TURP).
Comparison to Other Treatments
TUNA offers several advantages over traditional TURP:
- Minimally invasive
- Can be performed under local anesthesia
- Shorter recovery time
- Lower risk of bleeding
However, TURP remains more effective in treating severe symptoms and larger prostates. TUNA may be less suitable for prostates over 75 grams in volume.
Compared to medical therapy, TUNA provides a one-time treatment option. It can be particularly beneficial for patients who don’t respond well to medications or prefer to avoid long-term drug use.
TUNA’s effectiveness falls between medical therapy and TURP, making it a valuable alternative for select patients. The choice of treatment depends on individual factors, including prostate size, symptom severity, and patient preferences.
Frequently Asked Questions
Transurethral needle ablation (TUNA) offers a minimally invasive treatment option for benign prostatic hyperplasia. Patients considering this procedure often have questions about its effects, recovery, and comparison to other treatments.
What are the potential side effects of undergoing transurethral needle ablation?
Transurethral needle ablation may cause temporary urinary retention, urinary tract infections, or mild discomfort during urination. Some patients experience blood in their urine for a short period after the procedure.
These side effects typically resolve within a few days to weeks. Serious complications are rare but can include urethral stricture or damage to surrounding tissues.
How does transurethral needle ablation compare to transurethral resection of the prostate (TURP)?
TUNA is generally less invasive than TURP and can often be performed as an outpatient procedure. It typically results in fewer complications and a shorter recovery time compared to TURP.
However, TURP may provide more significant symptom relief for larger prostates. TUNA is often considered for patients who are not suitable candidates for TURP or prefer a less invasive option.
What can patients typically expect during the recovery period following a TUNA procedure?
Most patients can return home the same day as the TUNA procedure. They may experience mild discomfort or urgency when urinating for a few days to weeks.
Patients are usually advised to avoid strenuous activities for a short period. Full recovery and improvement in urinary symptoms may take several weeks to months.
In what circumstances is transurethral needle ablation of the prostate typically indicated?
TUNA is typically recommended for men with moderate to severe lower urinary tract symptoms due to benign prostatic hyperplasia (BPH). It is often considered when medication has not provided sufficient relief.
The procedure is particularly suitable for patients with prostate sizes between 20 and 50 grams. It may also be an option for those who cannot tolerate or wish to avoid long-term medication use.
How does TUNA differ from transurethral microwave thermotherapy (TUMT) in treating prostate issues?
TUNA uses radiofrequency energy delivered through needles to heat and destroy prostate tissue, while TUMT employs microwave energy. TUNA allows for more precise targeting of specific areas of the prostate.
TUNA may be more effective for larger prostates compared to TUMT. Both procedures aim to reduce prostate volume and improve urinary symptoms, but their application and outcomes can vary.
What should a patient understand about the efficacy and outcomes of a TUNA procedure?
TUNA has been shown to significantly improve urinary symptoms and flow rates in many patients. The effects can last for several years, though some may require additional treatments over time.
Patients should understand that while TUNA can provide substantial relief, it may not completely eliminate all BPH symptoms. The procedure’s success can vary based on individual factors such as prostate size and symptom severity.