Literature DB >> 12814680

Long-term evaluation of transurethral needle ablation of the prostate (TUNA) for treatment of symptomatic benign prostatic hyperplasia: clinical outcome up to five years from three centers.

Alexandre R Zlotta1, Xenofon Giannakopoulos, Odd Maehlum, Tonnes Ostrem, Claude C Schulman.   

Abstract

OBJECTIVE: TUNA has been demonstrated to be a safe and effective therapy for BPH. However the major criticism, as with all alternative treatments for BPH, was the lack of long-term data. We present the clinical outcome of patients treated by TUNA and followed for 5 years.
METHODS: 188 consecutive patients with symptomatic BPH treated with TUNA were followed for five years in three different centers. All patients were treated using the TUNA II or TUNA III catheters under local anesthesia only without general or spinal anesthesia. Baseline and 5-year follow-up evaluation included urinary peak flow, International Prostate Symptom Score (IPSS) and post-void residual urine (PVR). The number of patients requiring additional medical or surgical treatment was recorded. Statistics were performed using the t-test.
RESULTS: At a mean follow-up of 63 months, mean urinary peak flow rate increased from 8.6 ml/s to 12.1 ml/s (p<0.01, t-test), IPSS and PVR decreased from 20.9 and 179 ml to 8.7 and 122 ml, respectively (both p<0.001, t-test). The percentage of patients who improved by at least 50% their peak uroflow and IPSS was 24% and 78% respectively. Mean prostate volume and PSA levels did not change significantly (53.9 cc vs. 53.8 cc and 3.3 vs. 3.6 ng/ml, respectively at 5 years, both p values > 0.05, t-test). Two patients died of unrelated comorbidities and 10 were lost for follow-up. Medical treatment was given to 12 patients (6.4%), a second TUNA performed in 7 patients (3.7%) and surgery indicated in 22/186 (11.1%). Overall 41/176 patients (188 at start, 2 deaths and 10 lost to follow-up) or 23.3% required additional treatment at 5 years follow-up following the original TUNA procedure.
CONCLUSIONS: TUNA is effective and provides good long-term clinical improvement at 5-year follow-up. TUNA treatment stands the test of time at 5-year follow-up with low and acceptable failure rates. More than 75% of the patients do not need additional treatment for BPH on the long run.

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Mesh:

Year:  2003        PMID: 12814680     DOI: 10.1016/s0302-2838(03)00218-5

Source DB:  PubMed          Journal:  Eur Urol        ISSN: 0302-2838            Impact factor:   20.096


  23 in total

1.  Recent advances in the surgical treatment of benign prostatic hyperplasia.

Authors:  Bernardo Rocco; Giancarlo Albo; Rafael Coelho Ferreira; Matteo Spinelli; Gabriele Cozzi; Paolo Dell'orto; Vipul Patel; Francesco Rocco
Journal:  Ther Adv Urol       Date:  2011-12

2.  2010 Update: Guidelines for the management of benign prostatic hyperplasia.

Authors:  J Curtis Nickel; Carlos E Méndez-Probst; Thomas F Whelan; Ryan F Paterson; Hassan Razvi
Journal:  Can Urol Assoc J       Date:  2010-10       Impact factor: 1.862

3.  Ahead of the curve.

Authors:  David B Nash
Journal:  Popul Health Manag       Date:  2013       Impact factor: 2.459

4.  [Therapy of benign prostate syndrome (BPS): guidelines of the German Urologists (DGU)].

Authors:  R Berges; K Dreikorn; K Höfner; S Madersbacher; M C Michel; R Muschter; M Oelke; O Reich; W Rulf; C Tschuschke; U Tunn
Journal:  Urologe A       Date:  2009-12       Impact factor: 0.639

5.  Effect of an employer-sponsored health and wellness program on medical cost and utilization.

Authors:  Hangsheng Liu; Katherine M Harris; Sarah Weinberger; Seth Serxner; Soeren Mattke; Ellen Exum
Journal:  Popul Health Manag       Date:  2012-07-23       Impact factor: 2.459

Review 6.  How I Handle Retreatment of LUTS Following a Failed MIST.

Authors:  Alexis E Te; Ahra Cho; Bilal I Chughtai
Journal:  Curr Urol Rep       Date:  2021-06-11       Impact factor: 3.092

7.  [Benign prostatic syndrome (BPS). Ablative treatments].

Authors:  O Reich; M Seitz; C Gratzke; B Schlenker; A Bachmann; C Stief
Journal:  Urologe A       Date:  2006-06       Impact factor: 0.639

Review 8.  Management of non-complicated BPH: proposition of a renewed decision tree.

Authors:  Francois Desgrandchamps; Alexandre de la Taille; Abdel-Rahmène Azzouzi; Marc Fourmarier; Olivier Haillot; Bertrand Lukacs; Christian Saussine
Journal:  World J Urol       Date:  2006-06-21       Impact factor: 4.226

9.  Histotripsy of the prostate: dose effects in a chronic canine model.

Authors:  Timothy L Hall; Christopher R Hempel; Kirk Wojno; Zhen Xu; Charles A Cain; William W Roberts
Journal:  Urology       Date:  2009-07-22       Impact factor: 2.649

Review 10.  Measurement of benign prostatic hyperplasia treatment effects on male sexual function.

Authors:  T A Skolarus; J T Wei
Journal:  Int J Impot Res       Date:  2009-06-18       Impact factor: 2.896

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