[Treatment of benign prostatic hyperplasia by radiofrequency (TUNA): a monocentric study of 28 cases treated in ambulatory surgery].

Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie · 2009 · Benefit · Low evidence

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BenefitLow evidencePaper 2777

Study snapshot

PublicationProgres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie · 2009

Study typeother

Reported directionBenefit

Evidence ratingLow

Abstract

AIM: To assess the feasibility of ambulatory surgery in the treatment of benign prostatic hyperplasia using radio frequency (TUNA) and evaluate its place in terms of efficiency among other minimally invasive surgical techniques. METHOD: Fifty-four patients suffering from benign prostatic hyperplasia and for whom medical treatment was ineffective, were treated with radio frequency between September 2004 and June 2007. Among them, 28 patients, whose average age was 65.8 (aged 52-82), were selected for Transurethral Needle Ablation (TUNA) as outpatients. Urine status was assessed before and after TUNA treatment using the International Prostate Score System, the Quality Of Life-score to urinary symptoms, the measures of the maximal flow rate and of the residual urine. The erectile function was assessed using the five-item version of the International Index of Erectile Function (IIEF-5). RESULTS: With an average regression of 12.14 months, a significant improvement in urine status was observed with an average IPSS score passing from 22.4 to 9.75 and an average quality of life score passing from 4.9 to 1.9. The maximum flow rate and average flow volume increased significantly from 8.66 to 14.6 ml/s and from 202 to 248.4 ml respectively. Average urine residue was reduced from 177.4 to 112.2 ml (p<0.05). The IIEF-5 score did not increase significantly (14.1 versus 12.8). There were no cases of patients being rehospitalised. One case of prostatitis and six cases of acute urinary retention were observed at the postoperative stage. The rate of retreat was 21.4%. CONCLUSION: TUNA treatment is a minimally invasive technique of benign prostatic hyperplasia which can be carried out in ambulatory surgery and which is effective for urinary symptoms with little risk of morbidity. It is an alternative to medical treatment and does not replace planned surgical treatment.

Machine Enhanced Logic

AI evidence extraction

Structured fields below were generated from the paper’s abstract and metadata to make the evidence easier to inspect. Automated extraction may be incomplete or incorrect; verify important details against the original paper.

Study typeother

Effect directionbenefit

PopulationPatients with benign prostatic hyperplasia for whom medical treatment was ineffective; outpatient subgroup treated with TUNA

Sample size54

ExposureRF

Evidence strengthLowConfidence: 74% · Peer reviewed: yes

Main findings

In the outpatient TUNA group (n=28), urinary symptom measures improved over a mean follow-up of 12.14 months (IPSS 22.4 to 9.75; QoL 4.9 to 1.9; maximal flow rate 8.66 to 14.6 ml/s; residual urine 177.4 to 112.2 ml; p<0.05). Erectile function (IIEF-5) did not increase significantly (14.1 vs 12.8). No rehospitalisations were reported; postoperative events included 1 prostatitis and 6 acute urinary retentions; retreatment rate was 21.4%.

Outcomes measured

International Prostate Score System (IPSS)
Quality of Life score related to urinary symptoms
Maximal flow rate
Average flow volume
Residual urine volume
Erectile function (IIEF-5)
Postoperative complications (prostatitis, acute urinary retention)
Rehospitalisation
Retreatment rate

Limitations

Monocentric study
Non-randomized design not described as controlled
Outpatient TUNA results reported for a selected subgroup (28 of 54 patients)
Follow-up duration reported as an average; longer-term outcomes not provided in abstract

View raw extracted JSON

{
  "study_type": "other",
  "exposure": {
    "band": "RF",
    "source": "medical device (TUNA radiofrequency ablation)",
    "frequency_mhz": null,
    "sar_wkg": null,
    "duration": null
  },
  "population": "Patients with benign prostatic hyperplasia for whom medical treatment was ineffective; outpatient subgroup treated with TUNA",
  "sample_size": 54,
  "outcomes": [
    "International Prostate Score System (IPSS)",
    "Quality of Life score related to urinary symptoms",
    "Maximal flow rate",
    "Average flow volume",
    "Residual urine volume",
    "Erectile function (IIEF-5)",
    "Postoperative complications (prostatitis, acute urinary retention)",
    "Rehospitalisation",
    "Retreatment rate"
  ],
  "main_findings": "In the outpatient TUNA group (n=28), urinary symptom measures improved over a mean follow-up of 12.14 months (IPSS 22.4 to 9.75; QoL 4.9 to 1.9; maximal flow rate 8.66 to 14.6 ml/s; residual urine 177.4 to 112.2 ml; p<0.05). Erectile function (IIEF-5) did not increase significantly (14.1 vs 12.8). No rehospitalisations were reported; postoperative events included 1 prostatitis and 6 acute urinary retentions; retreatment rate was 21.4%.",
  "effect_direction": "benefit",
  "limitations": [
    "Monocentric study",
    "Non-randomized design not described as controlled",
    "Outpatient TUNA results reported for a selected subgroup (28 of 54 patients)",
    "Follow-up duration reported as an average; longer-term outcomes not provided in abstract"
  ],
  "evidence_strength": "low",
  "confidence": 0.74,
  "peer_reviewed_likely": "yes",
  "keywords": [
    "benign prostatic hyperplasia",
    "BPH",
    "radiofrequency",
    "transurethral needle ablation",
    "TUNA",
    "ambulatory surgery",
    "urology"
  ],
  "suggested_hubs": []
}

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AI-extracted fields are generated from the abstract and metadata and may be incomplete or incorrect. This material is for informational purposes and is not medical advice.

Identifiers and source

DOI: 10.1016/j.purol.2008.10.016
PubMed: 19393538

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