TRANSURETHRAL NEEDLE ABLATION OF THE PROSTATE - CLINICAL-EXPERIENCE IN PATIENTS IN URINARY ACUTE RETENTION

Objective To evaluate the clinical outcome of patients in urinary rete ntion due to benign prostatic enlargement (BPE) treated using transure thral needle ablation (TUNA), an outpatient procedure requiring only l ocal intra-urethral anaesthesia and intravenous sedoanalgesia. Patient s and methods The TUNA technique was used in 38 patients in acute rete ntion due to BPE, 34 of whom were a poor surgical risk. A special cyst oscopic catheter device delivered low-level radiofrequency (RF) energy interstitially to a localized area of the prostate, producing necroti c lesions within the prostatic parenchyma. After treatment, all men we re evaluated using urinary flow rates, residual urine volume, the Inte rnational Prostate Symptom Score and quality of life score at 1, 3 and 6 months. Results The mean prostate size was 43.1 g (range 18-90). To lerance of the procedure when using topical anaesthetic and intravenou s sedation was excellent, Of the 38 patients treated using TUNA, 30 (7 9%) resumed voiding within a mean of 8.7 days (range 2-27). After 6 mo nths, the sustained mean peak flow rate was 10.4+/-3.4 mL/s and the me an residual volume was 76+/-45 mL. Five of the patients who did not re sume voiding after TUNA underwent retropubic prostatectomy and one pat ient underwent TURF, The mean prostate size in these patients was 55.7 g. Failure to void was associated with the treatment of too few areas of the prostate for its volume. Conclusion This study demonstrated th at TUNA is highly effective in relieving patients in urinary retention due to BPE and seems particularly suitable for treating patients who are at greater risk during surgery.