Abstract

Although transurethral resection of prostate (TUR-P) is considered as a “gold standard” for the surgical treatment of benign prostatic hyperplasia (BPH), the morbidity rate of this procedure is still about 3-18% so, the current trend is toward minimal invasive therapies. We evaluated the efficacy and safety of TUNA that a new minimal invasive procedure for the treatment of BPH.

23 patients who age above 40 years, no suspicion of prostate cancer according to clinical or laboratory findings, the prostate volume less than 70 grams, maximum urinary flow rate (Qmax) less than 15 ml/s and International Prostate Symptom Score (IPSS) greater than 13 were included the study. The mean age of patients was 61.2 years (range 55 to 71) and the mean prostate volume was 44.8 (33-70) grams. TUNA procedure was performed under epidural anesthesia. The mean operation time was 42 min. After the procedure, an urethral catheter was inserted to all patients and removed on first day. At the end of 6 months, Qmax, IPSS and Quality of Life (QOL) parameters were compared with preoperative values. The results were assessed by Wilcoxon signed rank test.

At 6-months follow-up, statistically significant improvement was obtained for Qmax, IPSS and QOL parameters (P=0.016, P=0.017, and P=0.014 respectively). Only one patient could not urinate and a urethral catheter was left for four days. After procedure, most of the patients had suffered from irritative symptoms for five to seven days. Mild temporary hematuria was observed in a few patients for two to three days. No patient required an additional procedure. Erectile dysfunction, incontinence or retrograde ejaculation was not seen. Significant improvement was observed in Qmax, IPSS, and QOL parameters, 66.3%, 62.1%, and 62.5% respectively.