Transurethral needle ablation of the prostate, or TUNA, is a treatment for an enlarged prostate gland. It can help relieve the symptoms of an enlarged prostate gland.
The prostate gland is part of a man's reproductive system. It is normally a little bigger than a walnut. It is located between the base of the bladder and the beginning of the penis. It surrounds the upper part of the urethra. (The urethra carries urine from the bladder out through the penis.) The prostate makes the fluid that nourishes and carries sperm.
For this procedure the urologist (a surgeon who specializes in problems of the kidneys and bladder) uses high-frequency radio waves to destroy the part of the prostate gland that is causing the problem.
When the prostate gland is enlarged it is called benign prostate hyperplasia, or BPH. When the prostate gets bigger than normal, it may put pressure on the urethra and cause problems with urination. You may feel the need to urinate urine often, sometimes even at night. The need to urinate can come on suddenly, which can make travel, work, and some social situations difficult or awkward. In severe cases BPH can completely block your ability to pass urine. This can cause kidney damage if not treated promptly.
TUNA is a possible treatment if your prostate gland is not severely enlarged. It is best to have this procedure before urine symptoms become severe or the prostate gland becomes too large. TUNA can often be done under local anesthesia, so it is a good choice if you need to try to avoid general or spinal anesthesia.
Examples of alternatives to this procedure include:
Some men may choose this procedure because they are unable to tolerate the medicines or the medicines are not relieving their symptoms. Ask your healthcare provider about your choices for treatment.
Find someone to give you a ride home after the procedure. Although you should not expect severe tiredness or discomfort, it’s always a good idea to arrange for someone to help you with meals for a day or two after the procedure.
If you may be going home with a catheter for a few days after the procedure, ask for instructions on how to use the catheter and urine collection bag. It’s best to learn about this before your surgery, when you are most alert and able to understand and remember the directions.
On the day of surgery, do not eat or drink anything before the surgery, not even coffee, tea, or water.
If you take some medicines daily, ask your healthcare provider if you should take any of your medicines before surgery. If you take blood thinners, daily aspirin, or anti-inflammatories such as ibuprofen or naproxen, ask your provider if you need to stop them before surgery. If you do need to stop taking your medicines, ask your provider when you can start taking them again. If you need a minor pain reliever in the week before surgery, choose acetaminophen rather than aspirin, ibuprofen, or naproxen. This helps avoid extra bleeding during surgery.
Follow any other instructions your healthcare provider gives you.
You will be given a local anesthetic to numb the penis and urethra. You will have an IV (intravenous line), so you can be given more pain medicine if necessary.
Once you are numb, the surgeon will pass a scope through the urethra and into the bladder. The scope is a thin, lighted tube with lenses like a microscope. With the scope the surgeon will be able to see the area where the enlarged prostate is causing problems. Fluid will be passed into the bladder to stretch the bladder and help your provider see the area better.
The surgeon will put needles into the prostate gland and send high-frequency radio waves through the needles. The radio waves will destroy the tissue around the needles.
While you are still numb, a catheter (tube) may be inserted into the penis and the urethra and then into the bladder. The catheter can help the bladder drain for the first few days after the procedure.
The procedure takes about 30 minutes
Most men can go home the same day as their surgery.
If you have a catheter, it will probably need to stay in for 2 to 3 days. Do not try to remove it. Your healthcare provider will remove the catheter.
Most men are able to go back to work in 1 to 2 weeks.
Ask your provider how to care for yourself and when you should come back for a checkup.
This procedure can relieve symptoms with only minor surgery and local anesthesia. Research is showing that over 75% of men who have had TUNA are doing well and having few or no symptoms 5 years after their surgery.
With even minor surgery there is risk of infection or bleeding. Painful urination and blood in your urine are common for the first day or two. You may have problems passing urine and may need to use a catheter for a few days.
Because this procedure has been used for treatment of BPH for just a few years, there is not a lot of information about long-term side effects or outcomes. However, so far the results seem to be very good relief of urinary symptoms with few or no major complications compared to major prostate surgery (TURP).
After surgery, follow your provider’s instructions for taking care of yourself. If you have not been given specific instructions about when to call your provider, here are some guidelines:
Call your provider right away if:
Call during office hours if:
