[Treatment of benign hyperplasia of the prostate using thermal transurethral needle ablation (TUNA)]

Transurethral needle ablation of the prostate (TUNA) is a new, fast and minimally invasive device that produce a selective necrosis of the prostatic gland by delivering low level radiofrequency energy. We describe our experience with this new technique. A total of 42 patients suffering from symptomatic BPH were treated with this procedure. The original generator was used in 27 patients (group 1). A new generator allowing a more homogeneous application of intraprostatic temperature was used in 15 patients (group 2). The patients pretreatment evaluation consisted of World Health Organization symptom score and quality of life, digital rectal examination, uroflowmetric parameters, residual volume, transrectal ultrasound and PSA. Follow-up was performed using the same pretreatment parameters at one month, three months, six months and twelve months. All patients were treated using urethral xylocaine with intravenous or intramuscular sedation (petidine clorhidrate) and tolerance was good. IPSS and quality of life decreased significantly in both groups at first month after treatment and kept low up to twelve-month control. Peak flow rate increased from 7.7 +/- 3.7 ml/sec to 10 +/- 4.1 ml/sec at the twelve-month control in group 1 (p > 0.05), and from 7.6 +/- 2 ml/sec to 9.8 +/- 3.3 ml/sec in group 2 (p > 0.05). Residual volume decrease was statistically significant in group 2 (p < 0.05). No significant complications were encountered. Five patients in group 1 and one patient in group 2 required TURP some time in the follow-up (14%). In our experience, after one year of follow-up, improvement in subjective parameters is evident, although uroflowmetric improvement is moderate and with no statistically significance. No differences were found between both groups of treatment.