Transurethral needle ablation (also called TUNA or transurethral radiofrequency ablation) is a technique that uses low

energy In physics, energy (from Ancient Greek: ἐνέργεια, ''enérgeia'', “activity”) is the quantitative property that is transferred to a body or to a physical system, recognizable in the performance of work and in the form of hea ...

radio frequency Radio frequency (RF) is the oscillation rate of an alternating electric current or voltage or of a magnetic, electric or electromagnetic field or mechanical system in the frequency range from around to around . This is roughly between the ...

delivered through two needles to

ablate Ablation ( la, ablatio – removal) is removal or destruction of something from an object by vaporization, chipping, erosive processes or by other means. Examples of ablative materials are described below, and include spacecraft material for ...

excess

prostate The prostate is both an accessory gland of the male reproductive system and a muscle-driven mechanical switch between urination and ejaculation. It is found only in some mammals. It differs between species anatomically, chemically, and phys ...

tissue. A

cystoscope Cystoscopy is endoscopy of the urinary bladder via the urethra. It is carried out with a cystoscope. The urethra is the tube that carries urine from the bladder to the outside of the body. The cystoscope has lenses like a telescope or microscope ...

catheter In medicine, a catheter (/ˈkæθətər/) is a thin tubing (material), tube made from medical grade materials serving a broad range of functions. Catheters are medical devices that can be inserted in the body to treat diseases or perform a surgi ...

deploys the needles toward the obstructing prostate tissue and is inserted into the

urethra The urethra (from Greek οὐρήθρα – ''ourḗthrā'') is a tube that connects the urinary bladder to the urinary meatus for the removal of urine from the body of both females and males. In human females and other primates, the urethra c ...

directly through the

penis A penis (plural ''penises'' or ''penes'' () is the primary sexual organ that male animals use to inseminate females (or hermaphrodites) during copulation. Such organs occur in many animals, both vertebrate and invertebrate, but males d ...

under

local anesthetic A local anesthetic (LA) is a medication that causes absence of pain sensation. In the context of surgery, a local anesthetic creates an absence of pain in a specific location of the body without a loss of consciousness, as opposed to a general a ...

before the procedure begins. The energy from the probe heats the abnormal prostate tissue without damaging the urethra. The resulting

scar tissue Scar tissue may refer to: Medicine * Scar, an area of fibrous tissue that replaces normal skin after injury * Granulation tissue, a product of healing in major wounds Film and television * ''Scar Tissue'' (1975 film), or ''Wanted: Babysitter'' ...

later atrophies, reducing the size of the prostate which in turn reduces the constriction of the urethra. It can be done with a

on an

outpatient A patient is any recipient of health care services that are performed by healthcare professionals. The patient is most often ill or injured and in need of treatment by a physician, nurse, optometrist, dentist, veterinarian, or other health care ...

basis. It takes about an hour to perform the procedure. It takes about 30 days for the ablated prostate tissue to resorb. Transurethral needle ablation can be used to treat

benign prostatic hyperplasia Benign prostatic hyperplasia (BPH), also called prostate enlargement, is a noncancerous increase in size of the prostate gland. Symptoms may include frequent urination, trouble starting to urinate, weak stream, inability to urinate, or loss o ...

(BPH). Some clinical studies have reported that TUNA is safe and effective, improving the

urine Urine is a liquid by-product of metabolism in humans and in many other animals. Urine flows from the kidneys through the ureters to the urinary bladder. Urination results in urine being excreted from the body through the urethra. Cellular ...

flow with minimal side effects when compared with other procedures, such as

transurethral resection of the prostate Transurethral resection of the prostate (commonly known as a TURP, plural TURPs, and rarely as a transurethral prostatic resection, TUPR) is a urological operation. It is used to treat benign prostatic hyperplasia (BPH). As the name indicates, ...

(TURP) and open

prostatectomy Prostatectomy (from the Greek , "prostate" and , "excision") as a medical term refers to the surgical removal of all or part of the prostate gland. This operation is done for benign conditions that cause urinary retention, as well as for pros ...

. However, other studies have reported that the procedure has a high failure rate, with the majority of patients requiring retreatment. Some patients have reported long-term

inflammation Inflammation (from la, inflammatio) is part of the complex biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or irritants, and is a protective response involving immune cells, blood vessels, and molec ...

of their prostate after undergoing the TUNA process. This is known as chronic

prostatitis Prostatitis is an umbrella term for a variety of medical conditions that incorporate bacterial and non-bacterial origin illnesses in the pelvic region. In contrast with the plain meaning of the word (which means "inflammation of the prostate"), the ...

Judgements in guidelines

* The

American Urological Association The American Urological Association (AUA) is a professional association in the United States for urology professionals. It has its headquarters at the William P. Didusch Center for Urologic History in Maryland. AUA works with many international o ...

(AUA) guidelines for the treatment of BPH from 2018 stated that "TUNA is not recommended for the treatment of LUTS/BPH". * The

European Association of Urology The European Association of Urology (EAU) is a non-profit organisation committed to the representation of urology professionals worldwide. All active urology professionals, including urology nurses, are eligible for membership of the EAU. The con ...

(EAU) has – as of 2019 – removed TUNA from its guidelines.

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 Edwards along with RonG. Lax, Hugh Sharky and Ingemar Lundquist, in

Menlo Park, California Menlo Park is a city at the eastern edge of San Mateo County within the San Francisco Bay Area of California in the United States. It is bordered by San Francisco Bay on the north and east; East Palo Alto, Palo Alto, and Stanford to the south ...

, before building an international global corporation headed up by LyleF. Brotherton. Vidamed was floated in an

IPO An initial public offering (IPO) or stock launch is a public offering in which shares of a company are sold to institutional investors and usually also to retail (individual) investors. An IPO is typically underwritten by one or more investment ...

on the US NASDAQ stock market in 1995 and then acquired by Medtronic in 2001. In 2011, Urologix, Inc. acquired the worldwide exclusive license to Prostiva radiofrequency therapy.

References

* This article contains text derived from the public domain document a
Pueblo.GPO.gov Main Page
Archived at

on July 16, 2012, and accessed on December 29, 2015. * ; Notes

External links

The TUNA entry in the public domain NCI Dictionary of Cancer Terms
{{authority control Male genital surgery Urologic surgery