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

Zlotta, Alexandre R.; Giannakopoulos, X; Maehlum, Odd; Ostrem, T; Schulman, Claude

doi:10.1016/s0302-2838(03)00218-5

Cited by 111 publications

(66 citation statements)

References 16 publications

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“…In addition, some Authors have reported that LUTS have a lower impact on QoL than sexual dysfunction or incontinence [1,[13][14][15]. To reduce the invasiveness of TURP, many minimally invasive surgical options have been proposed during recent decades (Table 4) [16][17][18][19][20][21][22][23][24].…”

Section: Discussionmentioning

confidence: 99%

Temporary implantable nitinol device (TIND): a novel, minimally invasive treatment for relief of lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH): feasibility, safety and functional results at 1 year of follow‐up

et al. 2015

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ObjectivesTo report the first clinical experience with a temporary implantable nitinol device (TIND; Medi-Tate â ) for the treatment of lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). Patients and MethodsIn all, 32 patients with LUTS were enrolled in this prospective study, which was approved by our Institutional Ethics Committee. Inclusion criteria were: age >50 years, International Prostate Symptom Score (IPSS) of ≥10, maximum urinary flow rate (Q max ) of ≤12 mL/s, and prostate volume of <60 mL. The TIND was implanted within the bladder neck and the prostatic urethra under light sedation, using a rigid cystoscope. The device was removed 5 days later in an outpatient setting. Demographics, perioperative results, complications (according to the Clavien system), functional results and quality of life (QoL) were evaluated. Follow-up assessments were made at 3 and 6 weeks, and 3, 6 and 12 months postoperatively. The Student's t-test, analysis of variance (ANOVA), Kruskall-Wallis test, and simple and multiple linear regression models were used in the statistical analyses. ResultsThe mean patient age was 69.4 years, the mean (standard deviation, SD) prostate volume was 29.5 (7.4) mL and the Q max was 7.6 (2.2) mL/s. The median (interquartile range, IQR) IPSS was 19 (14-23) and QoL score was 3 (3-4). All the implantations were successful, with no intraoperative complications recorded. The mean operative time (SD) was 5.8 (2.5) min and the median (IQR) postoperative stay was 1 (1-2) day. All but one of the devices (96%) was removed 5 days at after implantation in an outpatient setting. Four complications (12.5%) were recorded, including urinary retention (one, 3.1%), transient incontinence due to device displacement (one, 3.1%), prostatic abscess (one, 3.1%), and urinary tract infection (one, 3.1%). Multiple regression analysis failed to identify any independent prognostic factor for complications. There were statistically significant differences in the IPSS, QoL score and Q max when comparing pre-and postoperative results at every time point. After 12 months, the median (IQR) IPSS and QoL score were 9 (7-13) and 1 (1-2), respectively, and the mean (SD) Q max was 12 (4.7) mL/s. The mean variations with respect to baseline conditions at the same time points were À45% for the IPSS and +67% for Q max . At 12 months after surgery (last followup visit), no patients required medical therapy or surgical procedures for BPH. ConclusionTIND implantation is a feasible and safe minimally invasive option for the treatment of BPH-related LUTS. The functional results are encouraging and the treatment significantly improved patient QoL. Further studies are required to assess durability of TIND results and to optimise the indications of such a procedure.

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Section: Discussionmentioning

confidence: 99%

Temporary implantable nitinol device (TIND): a novel, minimally invasive treatment for relief of lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH): feasibility, safety and functional results at 1 year of follow‐up

et al. 2015

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“…[66][67][68] TUNA is not an insurable service anywhere in Canada at this time; patients are required to pay for this procedure.…”

Section: Transurethral Needle Ablation (Tuna)mentioning

confidence: 99%

2010 Update: Guidelines for the management of benign prostatic hyperplasia

Nickel

Méndez-Probst

Whelan

et al. 2013

CUAJ

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“…Use of radiofrequency for the treatment of BPH has evolved considerably in the recent years with introduction of newer generation of transurethral needle ablation (TUNA) devices. In the reported work by Zlotta and colleagues (Zlotta et al, 2003) patients were treated using the TUNA II or TUNA III catheters under local anesthesia only without general or spinal anesthesia. The authors reported that TUNA is effective and provides good long-term clinical improvement at 5-year follow-up.…”

Section: Prostate Surgery For Bphmentioning

confidence: 99%