Name of the Procedure:

Transurethral Destruction of Prostate Tissue by Radiofrequency Thermotherapy (also known as TUNA or Transurethral Needle Ablation)

Summary

Transurethral destruction of prostate tissue by radiofrequency thermotherapy is a minimally invasive procedure that uses heat from radiofrequency energy to reduce prostate tissue. This helps alleviate symptoms associated with an enlarged prostate by improving urine flow.

Purpose

This procedure addresses benign prostatic hyperplasia (BPH), which is a non-cancerous enlargement of the prostate gland. The goal is to reduce urinary symptoms such as difficulty starting urination, weak stream, and frequent urination, thereby improving the patient's quality of life.

Indications

• Difficulty starting urination
• Weak or interrupted urine flow
• Frequent urination, especially at night
• Urgency to urinate
• Incomplete emptying of the bladder

Patient criteria:

• Men diagnosed with BPH
• Those who have not responded to or prefer not to take medication
• Patients seeking an alternative to more invasive surgical options

Preparation

• Patients may be asked to fast for several hours before the procedure.
• Medication adjustments might be necessary, especially blood thinners.
• Diagnostic tests like a urodynamic study or prostate exam to assess the size and condition of the prostate.

Procedure Description

1. The patient is positioned, and local anesthesia or light sedation may be administered.
2. A cystoscope is inserted through the urethra to visualize the prostate.
3. Needle electrodes are inserted into the prostate tissue via the cystoscope.
4. Radiofrequency energy is delivered through the electrodes to generate heat, which destroys targeted prostate tissue.
5. The destroyed tissue is then reabsorbed by the body over time.
6. The equipment is removed, and the patient is monitored for a short period.

Duration

Typically, the procedure takes about 30-60 minutes.

Setting

The procedure is performed in an outpatient clinic, hospital, or surgical center.

Personnel

• Urologist
• Nurse
• Anesthesiologist (if sedation is used)
• Medical technician

Risks and Complications

• Temporary difficulty urinating
• Risk of infection
• Bleeding during or after the procedure
• Temporary discomfort or pain in the pelvic area
• Rare risks include injury to the urethra or bladder

Benefits

• Improved urine flow and reduced urinary symptoms
• Minimally invasive with quicker recovery compared to traditional surgeries
• Most patients notice an improvement in symptoms within a few weeks

Recovery

• Patients may experience mild discomfort immediately after the procedure.
• Avoid strenuous activities for a few days.
• Drink plenty of fluids to flush out the urinary system.
• Possible catheter placement temporarily, if necessary.
• Follow-up appointments to monitor progress and address any issues.

Alternatives

• Medications (alpha-blockers, 5-alpha-reductase inhibitors)
• Surgical options (TURP - Transurethral Resection of the Prostate, Prostatectomy)
• Minimally invasive procedures like laser therapy and microwave thermotherapy

Pros and cons of alternatives:

• Medications may take longer to show improvement and can have side effects.
• TURP and Prostatectomy offer more permanent solutions but are more invasive with longer recovery times.
• Laser and microwave therapies offer similar benefits but may have different recovery profiles.

Patient Experience

• The patient may feel pressure or mild discomfort during the procedure.
• Mild pain or discomfort may last for a few days post-procedure.
• Pain management includes over-the-counter painkillers, hydration, and rest.
• Most patients can return to normal activities within a few days to a week, with full benefits realized in a few weeks.