Transurethral needle ablation (TUNA) for benign prostatic hyperplasia

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 but does require a spinal anesthetic, and usually a sedative is given to make you drowsy.

One study notes that after 1 year, TUNA reduced the American Urological Association (AUA) symptom index by 13 points while transurethral resection of the prostate (TURP) reduced it by 15 points.¹ But TUNA was associated with fewer complications than TURP.²

Needle ablation has minimal complications, the most common being an inability to urinate (urinary retention) in the first 24 hours after surgery and pain while urinating. Sexual ability is generally not affected.¹

The main advantages of this treatment are:

• It can be done without an overnight stay in the hospital.
• It has a short recovery time, although the symptoms may take longer to improve.
• It has minimal side effects.

The main disadvantages of this treatment are:

• It is not yet known how long the treatment is effective.
• It may not work well for men with large prostates.

Citations

1. 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.
2. Webber R (2006). Benign prostatic hyperplasia, search date May 2005. Online version of BMJ Clinical Evidence. Also available online: http://www.clinicalevidence.com.