Transurethral needle ablation (tuna™): new minimally invasive therapeutic approach for symptomatic equivocally obstructed bph patients

Franco Berqamaschi, Biagio Campo, Giorgio Ordesi, Tullio Torelli, Piero Corrada, Livio Zanitzer

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INTRODUCTION AND OBJECTIVES: About 30% of patients (PTS) are unsatisfied after TURP. Usually, they are minimally or equivocally obstructed before teraphy (Abrams/Griffiths nomogram). New alternative , really effective treatment is necessary for this group of patients. We have a previous positive experience with TUNA treatment in BPH patients and consequentely a prospective study was done to compare efficacy and complications of TUNA™ versus TURP in symptomatic PTS with minimally or equivocal obstruction in Abrams-Griffiths nomogram. METHODS: 81 PTS (mean age 53.2 years) were evaluated : 38 in the TUNA™ arm and 43 in the TURP arm. TUNA PTS were treated without anesthesia and as outcome procedure. Selection criterias were: (International Prostate Symptom Score) IPSS > 13 and detrusorial pressure at maximum flow <55 cm H2O, Schaeffer Classes 2 or 3, maximum flow rate 11 15 ml/sec , no endoscopic evidence of bladder neck contracture. All patients were re-evaluated at 6 , 12 and 18 months following treatment by pressure/flow study, uroflowmetry, IPSS and detailed sexual history. RESULTS: No serious complications were noted in either groups.Antegrade ejaculation was preserved in all patients treated with TUNA™ , whereas all PTS .except one, treated by TURP developed retrograde ejaculation and two patients in the TURP group experienced post-operative erectile dysfunction. TUNA patients showed good improvement in IPSS from 16.8 +/- 2.2 to 5.2 +/-1.7 and 5.1 +/-1.6 respectively at the twelve and eightenth month of the followup. TURP patients showed similary results from 18.2 +/- 2.1 to 9.4 +/- 2.1 and 8.9 +/- 1.8 (12 and 18 months). Urodynamics results are reporte in the table: TUNA PTS TURP PTS MONTHS PDet/QMax Q Max PDettQ Max Q Max pre 63.2+1-5.6 12.9+/-0.9 B8.5+/-7.4 11.2+M.6. 12 36.7-/-6.3 16.1+/-3.8 25.H-/-6.7 - 18.3+/-3.56 18 37.2+/-6.1 15.3+/-3.5 27.4+/-5.8 18.5+/-3.2 -p<0.001 CONCLUSION: TUNA is a really alternative advantageous theraphy in selected patients ( high IPSS and equivocally obstructed), because anesthesia free, outcome procedure, less costs, absence of post-operative sexual sequelae and short learning curve.

Original languageEnglish
Pages (from-to)187
Number of pages1
JournalBritish Journal of Urology
Issue numberSUPPL. 2
Publication statusPublished - 1997

ASJC Scopus subject areas

  • Urology


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