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

Yu Xi Terence Law, Wei Jing Kelven Chen, Liang Shen, Wei Jin Chua
Investigative and Clinical Urology 2019, 60 (5): 351-358

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.

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