The Therapeutic Effect of TUNA for the Treatment of BPH Based on Pressure-flow Studies

Kim, Sun Bong; Seong, Bong Mo; Woo, Won Hee

Abstract

PURPOSE: We investigated the effects of transurethral needle ablation (TUNA) in men with benign prostatic hyperplasia (BPH) using a pressure-flow study.
MATERIALS AND METHODS
A total of 25 patients with symptomatic BPH, and an obstructive pattern on urodynamics, were treated with TUNA. We evaluated the patients before TUNA treatment using the International Prostate Symptom Score (IPSS), quality of life scores (QOL), uroflowmetry, postvoid residual volume (PVR) and pressure-flow studies, for a mean of 6 months following treatment.
RESULTS
At 6 months after TUNA, the IPSS decreased from a mean of 22.69 to 7.65 (p<0.01). The QOL scores improved from a mean of 4.65 to 2.13 (p<0.01). The peak flow rate and PVR improved from a mean of 8.13ml/sec to 13.79ml/sec and 98.52ml to 39.52ml (p<0.01), respectively. A reduction in the mean detrusor pressure at maximum flow rate (67.21cmH2O to 47.43cmH2O, p<0.01) and the Abrams-Griffiths number (51.39 to 20.65, p<0.01) indicated that TUNA can significantly lower bladder pressure. With the exception of one patient, no patient complained of any severe side effects.
CONCLUSIONS
In patients with BPH, TUNA resulted significant clinical improvements, with no major complications, and slightly decreased the bladder outlet obstruction. We suggest that TUNA is a safe and effective method for treating bladder outlet obstructions due to BPH, especially, in patients at high risk of operative morbidity and mortality, and for aged patients afraid of sexual dysfunction and retrograde ejaculation.