TRANSURETHRAL NEEDLE ABLATION OF THE PROSTATE - A MINIMALLY INVASIVE TREATMENT FOR SYMPTOMATIC BENIGN PROSTATIC HYPERPLASIA

Transurethral needle ablation of the prostate, a relatively new minima lly invasive treatment modality for patients with bladder outlet obstr uction attributable to an enlarged prostate gland, has undergone exten sive evaluation by numerous investigators worldwide. The results to da te indicate that needle ablation is safe and effective for relieving s ymptoms in patients with benign prostatic hyperplasia, and the effect has been demonstrated to be durable for at least 2 years. Nevertheless , additional investigations with longer follow-up data are needed to a ddress the important issues of extended durability (5 to 10 years) and biophysiologic mechanism of action. Comparisons between transurethral needle ablation of the prostate and transurethral resection of the pr ostate (TURP) have revealed that the subjective and objective measures of response are comparable, although TURF has consistently displayed a slight advantage over needle ablation for most variables analyzed, e xcept quality of life store. The advantages of needle ablation over TU RF are (1) performance in the office as an outpatient procedure, (2) n o need for general or spinal anesthesia, (3) rapid recovery, (4) minim al side effects, and (5) one-time intervention. The following disadvan tages exist with needle ablation: (1) it may not be indicated or effec tive in patients with large prostate glands (75 g or more); (2) no pro state tissue is available for histologic evaluation; and (3) no long-t erm efficacy or re-treatment rate data have been published. Overall, t he available information indicates that transurethral needle ablation is a viable minimally invasive treatment that may be applicable in men with moderate to severe bladder outlet obstruction as a result of an enlarged prostate gland.