Transurethral needle ablation of the prostate

Transurethral needle ablation (also called TUNA or transurethral radiofrequency ablation) is a technique that uses low energy radio frequency delivered through two needles to ablate excess prostate tissue. A cystoscope/catheter deploys the needles toward the obstructing prostate tissue is inserted into the urethra directly through the penis under local anesthetic before the procedure begins. The energy from the probe heats the abnormal prostate tissue without damaging the urethra. The resulting scar tissue later atrophies, reducing the size of the prostate which in turn reduces the constriction of the urethra. It can be done with a local anesthetic on an outpatient basis.[1] It takes about an hour to perform the procedure.[2] It takes about 30 days for the ablated prostate tissue to resorb.[3]

Transurethral needle ablation of the prostate (TUNA)
ICD-9-CM60.97

Transurethral needle ablation can be used to treat benign prostatic hyperplasia (BPH).[4]

Some clinical studies have reported that TUNA is safe and effective, improving the urine flow with minimal side effects when compared with other procedures, such as transurethral resection of the prostate (TURP) and open prostatectomy.[1][5][6] However, other studies have reported that the procedure has a high failure rate, with the majority of patients requiring retreatment.[7] Some patients have reported long-term inflammation of their prostate after undergoing the TUNA process. This is known as chronic prostatitis.

Judgements in guidelines
  • The American Urological Association (AUA) guidelines for the treatment of BPH from 2018 stated that "TUNA is not recommended for the treatment of LUTS/BPH".[8]
  • The European Association of Urology (EAU) has - as of 2019 - removed TUNA from its guidelines.[9]

History

The TUNA system was pioneered by Stuart Denzil Edwards. The device was the main product for a startup company called Vidamed. Vidamed was founded in 1992 by Stu D. Edwards along with Ron G. Lax, Hugh Sharky and Ingemar Henry Lundquist, in Menlo Park, California, prior to building an international global corporation headed up by Lyle F. Brotherton. Vidamed was floated in an IPO on the US NASDAQ stock market in 1995 and then acquired by Medtronic in 2001.[10] In 2011, Urologix, Inc. acquired the worldwide exclusive license to Prostiva RF therapy.[11]

References
  • This article contains text derived from the public domain document at http://www.pueblo.gsa.gov/cic_text/health/prost-change/benign.htm. Archived at: https://web.archive.org/web/20120716232801/http://www.pueblo.gsa.gov/cic_text/health/prost-change/benign.htm on July 16, 2012, and accessed on December 29, 2015.
  •  This article incorporates public domain material from Dictionary of Cancer Terms. U.S. National Cancer Institute.
Notes
  1. Transurethral needle ablation (TUNA) Why it's done - Mayo Clinic
  2. Transurethral needle ablation (TUNA) What you can expect - Mayo Clinic
  3. Transurethral needle ablation (TUNA) Results - Mayo Clinic
  4. Benign prostatic hyperplasia (BPH) Treatments and drugs - Mayo Clinic
  5. Steele GS; Sleep DJ (November 1997). "Transurethral needle ablation of the prostate: a urodynamic based study with 2-year followup". The Journal of Urology. 158 (5): 1834–8. doi:10.1016/S0022-5347(01)64140-5. ISSN 0022-5347. PMID 9334612. Wikidata Q28251674.
  6. Tubaro A; De Nunzio C; Miano R (1 January 2007). "Transurethral needle ablation of the prostate". Current Opinion in Urology. 17 (1): 7–11. doi:10.1097/MOU.0B013E328011AB98. ISSN 0963-0643. PMID 17143104. Wikidata Q28276946.
  7. Rosario DJ; Phillips JT; Chapple CR (March 2007). "Durability and cost-effectiveness of transurethral needle ablation of the prostate as an alternative to transurethral resection of the prostate when alpha-adrenergic antagonist therapy fails". The Journal of Urology. 177 (3): 1047-51; discussion 1051. doi:10.1016/J.JURO.2006.10.042. ISSN 0022-5347. PMID 17296409. Wikidata Q28287880.
  8. Foster HE, Barry MJ, Dahm P, Gandhi MC, Kaplan SA, Kohler TS (2018). "Surgical Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA Guideline". J Urol. 200 (3): 612–619. doi:10.1016/j.juro.2018.05.048. PMID 29775639.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  9. EAU: Management of Non-neurogenic Male LUTS - Summary of Changes 2019.
  10. "Medtronic agrees to acquire Vidamed". incubelabs.com. In Cube Labs. 2001-12-06. Retrieved 2013-07-08.
  11. "Urologix Corporate Milestones". urologix.com. Urologix, Inc. Retrieved 2013-03-19.
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