Safety and efficacy of transurethral needle ablation of the prostate for symptomatic outlet obstruction

Objectives To examine, in an observational study, the safety and efficacy of transurethral needle ablation (TUNA) of the prostate as a treatment for symptomatic benign prostatic enlargement. Patients and methods This prospective study included 71 symptomatic men with unequivocal obstruction on pressure‐flow urodynamics. The variables measured at baseline and up to 12 months after treatment included the American Urological Association (AUA)‐7 symptom index and an added quality‐of‐life question, the AUA BPH‐Impact Index, a sexual function score, transrectal ultrasonography of the prostate, a frequency‐volume chart, free‐flow uroflowmetry, post‐void residual urine volume (PVR) and pressure‐flow urodynamics. Transurethral resection of the prostate (TURP) was offered if the symptoms failed to resolve at any time during the follow‐up period. TUNA was performed under local anaesthetic and sedation in 63 (89%) men and as a day‐case procedure in 10 (14%). Five patients were on warfarin which was not discontinued. Results There were no serious treatment‐related adverse events. Eight of the initial nine patients who were not routinely catheterized after treatment with TUNA developed acute urinary retention. Although some haematuria occurred in all patients, only one (1.4%) developed catheter blockage by clot. There were no problems with bleeding in those patients on warfarin at the time of treatment. The mean (95% confidence interval, CI) AUA‐7 index fell from 23 (1.7) to 10.6 (1.8) (P