How do TUNA and TURP compare for benign prostatic hyperplasia?

Marc B. Garnick, MD
Hematology & Oncology
A randomized, prospective clinical trial published in The Journal of Urology compared the safety and effectiveness of transurethral needle ablation (TUNA), a procedure that uses radio waves to heat and destroy prostate cells obstructing the urethra, with transurethral resection of the prostate (TURP) -- the most common procedure for benign prostatic hyperplasia (BPH), in which excess prostate tissue is cut away.

Researchers at seven centers in the United States enrolled 121 men in the trial; 65 underwent TUNA, and 56 had TURP. Over five years, both groups of men reported significant improvement in symptoms, quality of life, urine flow, and post-void residual volume (the amount of urine left in the bladder after attempting to void). But in most cases, the improvements were greater among the TURP patients. Patients who had TURP were less likely to need a second procedure than TUNA patients -- 1.8% versus 13.8%.

However, patients undergoing TURP experienced more adverse events, or side effects, of the procedure than patients undergoing TUNA. For example, the incidence of erectile dysfunction following TUNA was 3.1%, versus 21.4% for TURP. None of the patients in the TUNA group experienced retrograde ejaculation, but 41% of the patients who underwent TURP did.

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