Transurethral needle ablation (TUNA) — also known as radiofrequency ablation — is an outpatient procedure to treat urinary symptoms caused by an enlarged prostate.
A combined visual and surgical instrument (cystoscope) is inserted through the tip of your penis into the tube that carries urine from your bladder (urethra). The prostate surrounds the urethra. Using the cystoscope, your doctor guides a pair of tiny needles into the prostate tissue that is pressing on the urethra.
Radio waves are then passed through the needles, generating heat that creates scar tissue. Special shields protect the urethra from the heat. The scarring shrinks prostate tissue, allowing urine to flow more easily.
TUNA is one of several minimally invasive treatment options for an enlarged prostate, a condition known as benign prostatic hyperplasia (BPH). 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.
TUNA helps reduce urinary symptoms caused by BPH, including:
TUNA might also be done to treat or prevent complications due to blocked urine flow, such as:
TUNA can offer several advantages over other methods of treating BPH, such as transurethral resection of the prostate (TURP) and open prostatectomy. Possible advantages include:
TUNA is generally safe with few if any major complications. Possible risks of TUNA include:
Several days before surgery, your doctor might recommend that you stop taking medications that increase your risk of bleeding, such as:
Your doctor will likely prescribe an antibiotic to prevent a urinary tract infection.
You won't be able to drive yourself home after the procedure that day or generally if you have a catheter in your bladder. Arrange for someone to take you home.
You might not be able to work or do strenuous activity for two to three days after surgery. Ask your doctor how much recovery time you might need.
You'll be given a local anesthetic to numb the prostate area. The anesthetic might be inserted through the tip of your penis, or given in a shot via your rectum or in the area between your scrotum and anus.
You might also have intravenous (IV) sedation. With IV sedation, you'll be drowsy but remain conscious during the procedure.
Using the scope, your doctor will insert small needles into your prostate. You might feel a little pain or discomfort when the radio waves pass through the needles to heat and destroy prostate tissue.
You will likely have a urinary catheter in place because of swelling that blocks urine flow. The catheter is generally removed after one to three days. You will likely need to take antibiotics to prevent a urinary tract infection.
You might notice:
It can take several weeks for you to see significant improvement in your urinary symptoms. That's because your body needs time to break down and absorb prostate tissue that has been destroyed. It can take a few months for some men to notice significant improvement.