Investig Clin Urol.  2019 Sep;60(5):351-358. 10.4111/icu.2019.60.5.351.

Is transurethral needle ablation of prostate out of fashion? Outcomes of single session office-based transurethral needle ablation of prostate in patients with symptomatic benign prostatic hyperplasia

• Law YX
• Chen WJ
• Shen L
• Chua WJ

• KMID: 2455962
• DOI: http://doi.org/10.4111/icu.2019.60.5.351

Abstract

PURPOSE
Transurethral needle ablation (TUNA) is a minimally invasive procedure for the treatment of symptomatic benign prostatic hyperplasia (BPH). Compared to transurethral resection of the prostate (TURP), office-based TUNA is an attractive alternative as it is minimally invasive and avoids general anaesthesia. The aim of this study is to evaluate the efficacy of single session office-based TUNA.
MATERIALS AND METHODS
Data of 121 patients who had undergone TUNA was retrieved from June 2008 to March 2017. Patients were followed-up with visits at 1, 3, 6, and 12-months with the International Prostate Symptom Score (IPSS), quality of life (QoL) scoring and uroflowmetry.
RESULTS
Patients were 39 to 85 years old. The prostate volumes were 20.00 to 96.90 mL with a median of 26.95 mL. The median IPSS score pre-TUNA was 19, median QOL score pre-TUNA was 4 and median maximum urinary flow (Qmax) pre-TUNA was 10.3 mL/s. There is 65% improvement of IPSS post-TUNA (p<0.001). There is 75% improvement of QOL post-TUNA QOL (p<0.001). There is 35% improvement of Qmax post-TUNA Qmax (p<0.001). The mean relapse-free survival for TUNA is 6.123 years. The 1st, 3rd, and 5th year relapse-free survival rate were 91.7%, 76.6% and 63.7% respectively.
CONCLUSIONS
Our study is the first to investigate the use of a single-setting office-based TUNA requiring minimal sedation in the Asian community. Complication rates were low in our series, with no associated mortality. When applied to selected patients, TUNA is an effective and reasonably safe alternative for the treatment of symptomatic BPH.

Keyword

Prostate; Prostatic hyperplasia; Transurethral resection of prostate

MeSH Terms

Asian Continental Ancestry Group
Humans
Mortality
Needles
Prostate
Prostatic Hyperplasia*
Quality of Life
Survival Rate
Transurethral Resection of Prostate*
Tuna

Figure

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  Fig. 1 Kaplan–Meier plots. (A) Kaplan–Meier plot illustrates relapse-free survival rate to transurethral needle ablation (TUNA). (B) Kaplan–Meier plot illustrates relapse-free survival rate to TUNA comparison between group 1: side effects of medical therapy and not keen for long-term medical therapy versus group 2: failed medical therapy. (C) Kaplan–Meier plot illustrates relapse-free survival rate to TUNA comparison between group A: 20.00 to 30.00 mL prostate volume versus group B: 30.01 to 40.00 mL prostate volume versus group C: >40.01 mL prostate volume. (D) Kaplan–Meier plot illustrates operation free survival rate to TUNA. (E) Kaplan–Meier plot illustrates operation free survival rate to TUNA comparison between group 1: side effects of medical therapy and not keen for long-term medical therapy versus group 2: failed medical therapy. (F) Kaplan–Meier plot illustrates operation free survival rate to TUNA comparison between group A: 20.00 to 30.00 mL prostate volume versus group B: 30.01 to 40.00 mL prostate volume versus group C: >40.01 mL prostate volume.

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