Transurethral needle ablation for chronic nonbacterial prostatitis

Abstract

Objective To investigate the ef®cacy of transurethral needle ablation (TUNA) of the prostate for treating chronic nonbacterial prostatitis unresponsive to conservative therapies. Patients and methods Forty-two patients (mean age 38.5 years, range 25±52) with nonbacterial prostatitis in whom clinical management was unsuccessful in relieving the symptoms or signs of prostatitis were treated using TUNA. All patients had a high leukocyte count (>15 per high-power ®eld) in expressed prostatic secretions (EPS) with no bacterial growth in either urine or prostatic secretion cultures. Before TUNA all patients were evaluated using a symptom score, satisfaction score (quality of life) and an examination of prostatic secretions. All patients were reassessed using the same variables 1 and 3 months after TUNA. Of the 42 patients, 10 had their semen analysed before and 3 months after treatment.Results The mean (SD) symptom and satisfaction scores improved signi®cantly, from 11.02 (2.90) to 5.00 (2.61) and from 4.84 (0.57) to 1.26 (1.18), respectively, 3 months after TUNA (both P<0.05). Of the 42 patients, 30 (71%) had normal EPS results within 3 months of TUNA. Also, of 37 patients with high leukocyte counts (>100 per high-power ®eld) before TUNA, 26 (70%) had normal EPS results within 3 months afterward, and 29 (78%) had a satisfaction score of <3 points. Conclusions TUNA may be a possible treatment option for patients with chronic nonbacterial prostatitis that is unresponsive to conservative therapies. A long-term follow-up and randomized studies are needed to con®rm the ef®cacy of the TUNA against intractable chronic prostatitis.

Advancements in the Management of Urologic Chronic Pelvic Pain: What is New and What Do We Know?

“…An initial pilot study of 21 patients treated with TUNA demonstrated a significant improvement at 1-year follow-up [32]. Two further prospective studies demonstrated similar results over shorter follow-up periods of 3 months and 6 months, respectively [33,34]. Leskinen et al [35] performed a prospective, randomized, sham-controlled study of 33 patients that failed to show a significant difference between the TUNA group and sham group in pain score or quality of life at 12-month follow-up, raising doubts as to the effectiveness of this therapy.…”

Minimally invasive therapies for prostatitis

“…Four patients showed complete resolution of symptoms and three reported partial improvement. A larger uncontrolled study was published by Lee et al [19]. Forty-two patients with CP who had failed standard treatments were included.…”

Advanced therapy for prostatitis: Minimally invasive and invasive therapies

“…All of the patients had a decrease in the leukocyte count in EPS 1 month after treatment. More encouraging data came from an uncontrolled study of 42 patients with nonbacterial prostatitis (category IIIA) [44]. Seventy-eight percent of the patients had a satisfactory score using a nonvalidated symptom scale.…”