BPH / Enlarged Prostate Treatment With TUNA / Prostiva (Radiofrequency Ablation)

TUNA /PROSTIVA RF therapy is a minimally invasive, in-office and non-surgical procedure to shrink an enlarged prostate due to benign prostatic hyperplasia or BPH. Heat generated by radiofrequency waves is delivered to the prostate in a precise and controlled manner.

TUNA / Prostiva for Benign Prostatic Hyperplasia starts with a transrectal ultrasound which will be used to take a picture of the prostate, determine its dimensions, and to inject lidocaine as local anesthesia.  The patient will then be repositioned and the TUNA can commence.

The TUNA is performed through a cystoscope.  Each treatment takes 2 minutes and twenty seconds, and in the hands of Dr. Engel or Losee usually either five or seven treatments are performed total.  Thus, a TUNA takes approximately 15 minutes once started.  During the TUNA, there may be slight pain, but typically one experiences the feeling of needing to urinate.  Once finished, a catheter is inserted which the patient will go home with.   In Dr. Engel’s case, the patient takes their own catheter out on Sunday morning and follows up Monday or Tuesday just to make sure there is no urinary retention.

The TUNA procedure is performed in the downtown office of Urologic Surgeons of Washington only.  Patients will have been given prescriptions for Valium, antibiotics and also pain medicine for after the procedure.

Common experiences are blood in the urine, the feeling of needing to urinate while the catheter is present, or even bladder spasms.  If the catheter gets clogged, just take the catheter out early.  Occasionally, one must go to an emergency room to have a catheter flushed or replaced.  Fevers after a TUNA should never be considered normal and must be considered the sign of a rare infection.  This will require an immediate trip to the George Washington or Sibley Emergency Room to be treated.  We will be contacted from there.

The video below nicely displays the performance of a TUNA.  We perform a TUNA very similarly, but with fewer treatments.  We focus more on the bladder neck and less on other areas of the prostate.  Generally, we quote 75% with the TUNA in properly selected patients.

Over the course of the next several weeks, the treated tissue will slowly be absorbed into the body. As the body absorbs the extra tissue, the prostate begins to shrink and the patient will see incremental improvements in their symptoms. Patients will experience the full degree of improvement within 10 weeks of the procedure. We quote a 70-75% success rate with TUNA/Prostiva, and success, on average, lasts 5 years.

Frequently Asked Questions

When can I expect my BPH symptoms to go away?

Most patients will notice improvement within two to six weeks. However, results may vary depending on the severity and duration of symptoms and the size of the prostate treated. Full improvement may not occur for two to three months. Follow your post-procedure instructions as to when to stop taking your BPH medication.

What side effects are associated with PROSTIVA RF Therapy?

Possible side effects include obstruction, bleeding, blood in urine, pain/discomfort, urgency to urinate, increased frequency and urinary tract infection. Patients may also experience a minor burning sensation when urinating for one to two weeks following the treatment.

What is the risk of incontinence?

There were no reported cases of incontinence in the original clinical study for approval of this therapy. The surgeons at Urologic Surgeons of Washington generally quote a less than 1% risk of incontinence after TUNA/Prostiva,

Will there be any sexual side effects?

During the original clinical study conducted for the approval of this therapy, less than two percent of RF therapy patients experienced impotence and less than one percent of patients experienced retrograde ejaculation. We have noticed, however, a 10-20% incidence of reduced semen volume after a TUNA/Prostiva.