Francis Chinegwundoh

This is a relatively new technique to the UK, which I am able to offer. It has been widely used on the Continent and the USA for years.

With age, most men's prostates grow larger, resulting in irritating problems associated with urination. Benign prostatic hyperplasia (BPH) is a common condition affecting the prostate. It is a non-cancerous enlargement of the prostate that restricts the flow of urine from the bladder. Millions of men worldwide are affected by BPH, but fewer than five percent are receiving treatment. Fifty percent of men older than 50 and 80 percent of men older than 80 have some symptoms of BPH. This condition is the most common non-cancerous form of cell growth in men. While there is no definitive cause of BPH, factors that contribute to the condition include aging, hormones and growth factors.

Though BPH is not life threatening, it can lead to a reduced quality of life, causing discomfort, inconvenience, sleep disruption and embarrassment. BPH was traditionally treated by a method called Transurethral Resection of the Prostate (TURP). This involves inserting a scope into the urethra and removing a section of the obstructing prostate tissue. It involves surgical risks but remains a "standard."

Medication is also available to help treat BPH. Some relax the neck of the bladder while others shrink the prostate. These medications are effective, but not as effective as surgery. Within the past decade, a number of minimally invasive techniques have been developed to treat BPH. Transurethral Needle Ablation (TUNA) is one such technique that has fewer side effects than other minimally invasive laser or microwave treatments. The side effect profile also compares favorably to TURP.

How is TUNA performed?
During TUNA, the interior of the prostate is treated with low levels of radiofrequency energy in a manner which causes prostatic tissue coagulation or destruction. In the hands of a properly trained urologic surgeon, the procedure is rather simple to perform. Operating time is usually approximately thirty minutes. The procedure can almost always be performed using only local anesthesia and intra-venous sedation and is performed as a day case. During the TUNA procedure, a special lighted scope is inserted that employs two tiny needles that penetrate the prostate without damaging the wall of the urethra. The urologist then directs the needles into position and releases a controlled burst of radiofrequency energy which heats the enlarged prostate tissue to about 195 degrees without affecting nearby nerves, muscles or membranes. The two needles are moved into several different locations and the treatment repeated which destroys enough prostatic tissue to "open the pipes" a bit.
Over a period of a few months, the prostate shrinks away from the middle hole and opens the passageway and the narrowing in the urethra is reduced. Some patients are sent home with a small urinary catheter which is removed two to three days later and they can resume normal activity almost immediately. Other men may be able to avoid a catheter all together.

The procedure received marketing clearance from the U.S. Food and Drug Administration in 1996 for the treatment of symptoms due to urinary outflow obstruction secondary to benign prostatic hyperplasia (BPH) in men older than 50. Since its introduction, more than 33,000 TUNA procedures have been performed worldwide.