Long-term evaluation of transurethral needle ablation of the prostate (TUNA) for treatment of symptomatic benign prostatic hyperplasia: clinical outcome up to five years from three centers

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dc.contributor.authorZlotta, A. R.en
dc.contributor.authorGiannakopoulos, X.en
dc.contributor.authorMaehlum, O.en
dc.contributor.authorOstrem, T.en
dc.contributor.authorSchulman, C. C.en
dc.date.accessioned2015-11-24T19:06:26Z
dc.date.available2015-11-24T19:06:26Z
dc.identifier.issn0302-2838-
dc.identifier.urihttps://olympias.lib.uoi.gr/jspui/handle/123456789/20338
dc.rightsDefault Licence-
dc.subjectAgeden
dc.subjectAged, 80 and overen
dc.subjectBiopsy, Needleen
dc.subjectCatheter Ablation/methodsen
dc.subjectCohort Studiesen
dc.subjectFollow-Up Studiesen
dc.subjectHumansen
dc.subjectMaleen
dc.subjectMiddle Ageden
dc.subjectNorwayen
dc.subjectProstatic Hyperplasia/*pathology/*surgeryen
dc.subjectRisk Assessmenten
dc.subjectSensitivity and Specificityen
dc.subjectSeverity of Illness Indexen
dc.subjectSurgical Procedures, Minimally Invasive/methodsen
dc.subjectTime Factorsen
dc.subjectTransurethral Resection of Prostate/*methodsen
dc.subjectTreatment Outcomeen
dc.titleLong-term evaluation of transurethral needle ablation of the prostate (TUNA) for treatment of symptomatic benign prostatic hyperplasia: clinical outcome up to five years from three centersen
heal.abstractOBJECTIVE: TUNA has been demonstrated to be a safe and effective therapy for BPH. However the major criticism, as with all alternative treatments for BPH, was the lack of long-term data. We present the clinical outcome of patients treated by TUNA and followed for 5 years. METHODS: 188 consecutive patients with symptomatic BPH treated with TUNA were followed for five years in three different centers. All patients were treated using the TUNA II or TUNA III catheters under local anesthesia only without general or spinal anesthesia. Baseline and 5-year follow-up evaluation included urinary peak flow, International Prostate Symptom Score (IPSS) and post-void residual urine (PVR). The number of patients requiring additional medical or surgical treatment was recorded. Statistics were performed using the t-test. RESULTS: At a mean follow-up of 63 months, mean urinary peak flow rate increased from 8.6 ml/s to 12.1 ml/s (p<0.01, t-test), IPSS and PVR decreased from 20.9 and 179 ml to 8.7 and 122 ml, respectively (both p<0.001, t-test). The percentage of patients who improved by at least 50% their peak uroflow and IPSS was 24% and 78% respectively. Mean prostate volume and PSA levels did not change significantly (53.9 cc vs. 53.8 cc and 3.3 vs. 3.6 ng/ml, respectively at 5 years, both p values > 0.05, t-test). Two patients died of unrelated comorbidities and 10 were lost for follow-up. Medical treatment was given to 12 patients (6.4%), a second TUNA performed in 7 patients (3.7%) and surgery indicated in 22/186 (11.1%). Overall 41/176 patients (188 at start, 2 deaths and 10 lost to follow-up) or 23.3% required additional treatment at 5 years follow-up following the original TUNA procedure. CONCLUSIONS: TUNA is effective and provides good long-term clinical improvement at 5-year follow-up. TUNA treatment stands the test of time at 5-year follow-up with low and acceptable failure rates. More than 75% of the patients do not need additional treatment for BPH on the long run.en
heal.accesscampus-
heal.fullTextAvailabilityTRUE-
heal.identifier.secondaryhttp://www.ncbi.nlm.nih.gov/pubmed/12814680-
heal.journalNameEur Urolen
heal.journalTypepeer-reviewed-
heal.languageen-
heal.publicationDate2003-
heal.recordProviderΠανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικήςel
heal.typejournalArticle-
heal.type.elΆρθρο Περιοδικούel
heal.type.enJournal articleen

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