Surgery and Medical Treatments
Transurethral Needle Ablation (TUNA)
Medically reviewed by Dr. Paul Song M.D
A transurethral needle ablation (TUNA) is an outpatient procedure for treatment-resistant cases of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). The TUNA procedure heats the prostate up to 90 to 100 degrees Celsius (°C). It is considered a safe and easy treatment that can resolve urinary symptoms for some men. This procedure is also called radiofrequency ablation or RF therapy.
TUNA is also a treatment option for another prostate condition called benign prostatic hyperplasia (BPH), also known as enlarged prostate. To determine the right treatment choice for you, your doctor will consider how severe your symptoms are, what other health problems you have, and the size and shape of your prostate.Advertisement
There are a few studies on using TUNA. One study from Taiwan involved seven men with CP/CPPS who failed to respond to treatment for a year and a half. Using the TUNA procedure, they heated the prostate to a range of 90 to 100°C. The urethral temperature was maintained below 43°C by using a protective sheath and irrigation. After the treatment, four patients had complete resolution of their symptoms, and three patients experienced partial improvement. After one month, all seven patients had a decrease in their leukocyte count. The improvement was maintained during the subsequent follow-up. The researchers concluded, “from these results, TUNA is considered to be an effective, safe, and easy treatment for most patients with nonbacterial prostatitis.”
Another, larger study involved 42 patients with CP/CPPS. The mean symptoms and satisfaction scores improved significantly three months after having the TUNA procedure. The researchers concluded, “TUNA may be a possible treatment option for patients with chronic nonbacterial prostatitis that is unresponsive to conservative therapies.”
What Does the Transurethral Needle Ablation (TUNA) Procedure Involve?
The TUNA procedure can be done under oral sedation and using urethral gel. It does not require general or spinal anesthesia. Local anesthesia is placed using ultrasound or some other digital guidance. Before the procedure you physician may perform a transrectal ultrasonography.
During TUNA, a specially adapted visual instrument called a cystoscope is inserted through the tip of the penis into the urethra, which is the tube that carries urine from your bladder. Using the cystoscope, the doctor guides a pair of tiny needles into the prostate tissue that is pressing on the urethra. Then radio waves pass through the needles to create scar tissue. This scarring shrinks prostate tissue, opening up the urinary channel so that urine can flow more easily.
After the procedure you will need to wear a catheter for one to two days. Most men can return to work in two to three days. Your doctor will probably prescribe an antibiotic for three to five days after the procedure or after the catheter is removed.
What Are the Side Effects of TUNA?
There are some side effects of TUNA for prostatitis. Risks include urinary tract infection, worsening of prostatitis symptoms, or a new onset of symptoms such as irritative urinary symptoms (urgency, frequency, or pain). This procedure does not usually cause impotence or urinary incontinence. Make sure to talk to your doctor about your risk factors for TUNA.
In terms of treating BPH, a long-term study showed that after five years, more than 75% of patients did not need additional treatment. Other studies have shown that patients may need retreatment. While BPH is a different prostate condition, knowing how long the effects TUNA last for BPH can help us understand its possible long-term effects for prostatitis.
Reference for Transurethral Needle Ablation (TUNA):
Chiang PH, Tsai EM, Chiang CP. Pilot study of transurethral needle ablation (TUNA) in treatment of nonbacterial prostatitis. J Endourol. 1997 Oct;11(5):367-70.
Lee KC, Jung PB, Park HS, Whang JH, Lee JG. Transurethral needle ablation for chronic nonbacterial prostatitis. Curr Urol Rep. 2002 BJU Int. 2002 Feb;89(3):226-9.