Transurethral Needle Ablation for the Management of Benign Prostatic Hyperplasia - Preliminary Report

Abstract

To investigate the effectiveness and safety of transurethral needle ablation of prostate (TUNA), these procedures have been used for the management of six patients with symptomatic benign prostatic hyperplasia (BPH). Another six patients who underwent transurethral resection of the prostate (TURP) were also enrolled in this study as a comparative group. These 12 patients were from 63 to 78 years (mean: 70.5) old. Preoperative evaluation included digital rectal examination, American urological association (AUA) symptom scoring, uroflow rate, serum prostate specific antigen (PSA), transrectal ultrasonography and cystourethroscopy. In the TUNA group, the initial two patients were treated under spinal anesthesia and the other four were under topical anesthesia and intravenous sedation. All of the patients who underwent either TUNA or TURP tolerated the procedures well. In the TUNA group, all six patients have been followed up for more than three months. The mean peak flow rate increased from 11.5 ± 4.8 to 12.1 ± 1.9 mL/s and the mean AUA symptom score improved from an average of 26.2 ± 7.3 to 18.8 ± 4.3. In the TURP group, peak flow rate increased from 15.5 ± 6.7 to 19.5 ± 4.8 mL/ s, and AUA symptom score improved from 25.8 ± 9.2 to 13.3 ± 2.8 three months after operation. In the TUNA group, mild hematuria was found in all patients. Urinary retention developed in 4 patients, and urethral catheterization was needed from 2 to 14 days (mean 7.0). In conclusion, these preliminary results suggest that TUNA is an effective and minimally invasive procedure for the treatment of BPH. However, the early effect of TUNA is not equivalent to TURP.