[Transurethral needle ablation Prostiva for treating symptomatic benign prostatic hyperplasia: a review]

Benign prostatic hyperplasia (BPH) is a common disease affecting a large proportion of men older than 50 years. There are multiple treatment options for BPH including medications, minimally invasive options such as transurethral needle ablation (Tuna) and transurethral microwave therapy (TUMT), and more invasive options such as transurethral laser vaporization and transurethral resection of the prostate (TURP). The minimally invasive options induce thermal injury to the BPH adenoma with a lower risk of permanent side effects than TURP. Tuna treatment is a minimally invasive technique of BPH which can be carried out in ambulatory surgery and which is effective for urinary symptoms with little risk of morbidity. It is an alternative to medical treatment and does not replace planned surgical treatment. Available evidence suggests that Tuna is a relatively effective and safe technique. It significantly improves BPH parameters but it does not reach the same level efficacy and long-lasting success as TURP. Also the Tuna procedure compares favourably to combination medical therapy for the treatment of BPH on a cost basis. α-Blocker monotherapy is less costly than Tuna for 5 years, while the cost of 5α-reductase inhibitor monotherapy is approximately equivalent to that of Tuna for 5 years. From the payer's perspective, the break-even point between the Tuna(®) procedure and combination medical management occurs after approximately 2 years 7 months of treatment.