Transurethral Needle Ablation (TUNA) - Cost, Indications, Preparation, Risks, and Recovery

Transurethral Needle Ablation (TUNA) is a minimally invasive medical procedure designed to treat benign prostatic hyperplasia (BPH), a condition characterized by the enlargement of the prostate gland. This enlargement can lead to various urinary symptoms, including difficulty urinating, frequent urination, and a weak urine stream. TUNA utilizes radiofrequency energy delivered through thin needles inserted into the prostate tissue to destroy excess prostate cells, thereby reducing the size of the prostate and alleviating symptoms.

The procedure is performed under local anesthesia, allowing patients to remain awake and comfortable during the treatment. TUNA is typically conducted in an outpatient setting, meaning patients can return home the same day. The primary goal of TUNA is to improve urinary flow and overall quality of life for men suffering from BPH, providing a less invasive alternative to traditional surgical options.
 

Why is Transurethral Needle Ablation (TUNA) Done?

Transurethral Needle Ablation (TUNA) is recommended for men experiencing moderate to severe symptoms of BPH that significantly impact their daily lives. Common symptoms leading to this procedure include:

• Frequent urination, especially at night (nocturia)
• Urgency to urinate
• Difficulty starting or stopping urination
• Weak or interrupted urine flow
• Incomplete bladder emptying

These symptoms can be bothersome and may lead to complications such as urinary tract infections or bladder stones if left untreated. TUNA is typically considered when lifestyle changes, medications, or other non-invasive treatments have failed to provide adequate relief. The procedure is particularly suitable for men who prefer to avoid more invasive surgical options, such as transurethral resection of the prostate (TURP) or open prostatectomy.
 

Indications for Transurethral Needle Ablation (TUNA)

Several clinical situations and diagnostic findings may indicate that a patient is a suitable candidate for Transurethral Needle Ablation (TUNA). These include:

1. Diagnosis of Benign Prostatic Hyperplasia (BPH): A confirmed diagnosis of BPH is essential. This is typically established through a combination of medical history, physical examination, and diagnostic tests such as a digital rectal exam (DRE) and prostate-specific antigen (PSA) blood test.
2. Moderate to Severe Symptoms: Patients experiencing moderate to severe urinary symptoms that significantly affect their quality of life are prime candidates for TUNA. The American Urological Association (AUA) symptom index can help quantify the severity of symptoms.
3. Failed Conservative Treatments: Patients who have tried lifestyle modifications or medications (such as alpha-blockers or 5-alpha-reductase inhibitors) without satisfactory improvement may be considered for TUNA.
4. Desire for Minimally Invasive Options: Men who prefer a less invasive treatment option compared to traditional surgery may opt for TUNA, especially if they are concerned about the risks and recovery associated with more invasive procedures.
5. No Significant Bladder or Kidney Damage: TUNA is generally recommended for patients without significant bladder or kidney damage due to BPH. Imaging studies, such as ultrasound or CT scans, may be performed to assess the condition of the bladder and kidneys.
6. Age and Overall Health: While age alone is not a disqualifying factor, overall health and the presence of comorbid conditions will be considered. Patients should be able to tolerate the procedure and anesthesia.

In summary, Transurethral Needle Ablation (TUNA) is a valuable option for men suffering from BPH-related urinary symptoms, particularly when other treatments have not provided relief. By understanding the indications for this procedure, patients can engage in informed discussions with their healthcare providers about the best treatment options for their specific situations.
 

Contraindications for Transurethral Needle Ablation (TUNA)

Transurethral Needle Ablation (TUNA) is a minimally invasive procedure designed to treat benign prostatic hyperplasia (BPH) by reducing the size of the prostate. However, certain conditions or factors may make a patient unsuitable for this treatment. Understanding these contraindications is crucial for ensuring patient safety and optimal outcomes.

1. Severe Urinary Tract Infections (UTIs): Patients with active or recurrent UTIs may not be ideal candidates for TUNA. The presence of an infection can complicate the procedure and increase the risk of further complications.
2. Prostate Cancer: TUNA is specifically intended for benign conditions. If a patient has a diagnosis of prostate cancer, this procedure is not appropriate, as it does not address malignant tissue.
3. Severe Urethral Stricture: A significant narrowing of the urethra can hinder the ability to perform TUNA effectively. This condition may lead to complications during the procedure and affect the overall success rate.
4. Bleeding Disorders: Patients with clotting disorders or those on anticoagulant therapy may face increased risks of bleeding during and after the procedure. It is essential to evaluate these factors before proceeding with TUNA.
5. Anatomical Abnormalities: Any anatomical issues that could obstruct the procedure, such as severe pelvic deformities or abnormalities in the urinary tract, may disqualify a patient from undergoing TUNA.
6. Uncontrolled Diabetes or Other Chronic Conditions: Patients with poorly managed chronic conditions, such as diabetes, may have a higher risk of complications. It is vital to ensure that any underlying health issues are well-controlled before considering TUNA.
7. Patient Preference: Some patients may choose not to undergo TUNA due to personal preferences or concerns about the procedure. It is essential for patients to feel comfortable and informed about their treatment options.

By identifying these contraindications, healthcare providers can better assess whether TUNA is a suitable option for individual patients, ensuring a safer and more effective treatment experience.
 

How to Prepare for Transurethral Needle Ablation (TUNA)

Preparation for Transurethral Needle Ablation (TUNA) is an essential step in ensuring a successful procedure. Patients should follow specific pre-procedure instructions, undergo necessary tests, and take precautions to optimize their readiness for the treatment.

1. Consultation and Medical History: Before the procedure, patients will have a thorough consultation with their healthcare provider. This includes discussing medical history, current medications, and any allergies. It is crucial to disclose all medications, including over-the-counter drugs and supplements, as some may need to be adjusted or temporarily stopped.
2. Pre-Procedure Testing: Patients may undergo several tests to assess their overall health and the condition of their prostate. Common tests include:
   • Urinalysis: To check for infections or other urinary issues.
   • Blood Tests: To evaluate kidney function and prostate-specific antigen (PSA) levels.
   • Imaging Studies: Such as ultrasound, to visualize the prostate and surrounding structures.
3. Medication Adjustments: If patients are taking blood thinners or medications that affect bleeding, their healthcare provider may recommend stopping these drugs for a specified period before the procedure. It is essential to follow these instructions closely to minimize the risk of complications.
4. Hydration and Diet: Patients are typically advised to stay well-hydrated in the days leading up to the procedure. However, they may be instructed to avoid eating or drinking for a certain period before TUNA, especially if sedation or anesthesia will be used.
5. Arranging Transportation: Since TUNA may involve sedation, patients should arrange for someone to drive them home after the procedure. It is not safe to drive immediately following sedation.
6. Understanding the Procedure: Patients should take the time to understand what TUNA entails. This includes discussing any concerns with their healthcare provider and asking questions about what to expect before, during, and after the procedure.
7. Post-Procedure Care Instructions: Patients should receive clear instructions on what to expect after the procedure, including any signs of complications to watch for and when to follow up with their healthcare provider.

By following these preparation steps, patients can help ensure that they are ready for Transurethral Needle Ablation (TUNA) and can contribute to a smoother and more successful treatment experience.
 

Transurethral Needle Ablation (TUNA): Step-by-Step Procedure

Understanding the step-by-step process of Transurethral Needle Ablation (TUNA) can help alleviate any anxiety patients may have about the procedure. Here’s what typically happens before, during, and after TUNA.
 

Before the Procedure:

• Arrival and Check-In: Patients arrive at the medical facility and check in. They may be asked to change into a hospital gown.
• Pre-Procedure Assessment: A nurse or healthcare provider will review the patient’s medical history and confirm the procedure. Vital signs will be taken, and an intravenous (IV) line may be started for sedation or anesthesia.
• Sedation: Depending on the patient’s comfort level and the healthcare provider’s recommendation, sedation may be administered to help the patient relax during the procedure.
   

During the Procedure:

• Positioning: The patient is positioned comfortably, usually lying on their back with legs elevated. This position allows easy access to the urethra.
• Anesthesia: Local anesthesia is typically applied to the urethra to minimize discomfort. In some cases, general anesthesia may be used.
• Insertion of the Cystoscope: A thin, flexible tube called a cystoscope is gently inserted into the urethra and advanced to the prostate. This device allows the physician to visualize the prostate and surrounding tissues.
• Needle Ablation: Once the cystoscope is in place, specialized needles are inserted through the cystoscope. These needles deliver radiofrequency energy to the prostate tissue, causing it to heat up and shrink. The procedure usually takes about 30 to 60 minutes.
• Monitoring: Throughout the procedure, the healthcare team monitors the patient’s vital signs and comfort levels.
   

After the Procedure:

• Recovery: After TUNA, patients are moved to a recovery area where they are monitored as the sedation wears off. This may take about 30 minutes to an hour.
• Post-Procedure Instructions: Patients will receive instructions on managing any discomfort, such as taking over-the-counter pain relievers. They may also be advised to drink plenty of fluids to help flush out the urinary system.
• Follow-Up Appointments: A follow-up appointment will be scheduled to assess the effectiveness of the procedure and address any concerns.

By understanding the step-by-step process of TUNA, patients can feel more prepared and informed about what to expect, contributing to a more positive experience.
 

Risks and Complications of Transurethral Needle Ablation (TUNA)

Like any medical procedure, Transurethral Needle Ablation (TUNA) carries certain risks and potential complications. While many patients experience positive outcomes, it is essential to be aware of both common and rare risks associated with the procedure.
 

Common Risks:

1. Discomfort or Pain: Some patients may experience mild discomfort or pain in the pelvic area after the procedure. This is usually temporary and can be managed with over-the-counter pain medications.
2. Urinary Symptoms: Patients may notice changes in urinary habits, such as increased frequency, urgency, or mild incontinence. These symptoms typically improve over time.
3. Blood in Urine: It is common to see some blood in the urine (hematuria) for a few days following TUNA. This usually resolves on its own.
4. Urinary Tract Infection (UTI): There is a risk of developing a UTI after the procedure. Patients should be vigilant for symptoms such as fever, chills, or increased pain during urination.
    

Rare Risks:

1. Severe Bleeding: Although uncommon, some patients may experience significant bleeding during or after the procedure, which may require additional medical intervention.
2. Urethral Injury: There is a small risk of injury to the urethra during the insertion of the cystoscope or needles. This can lead to complications that may require further treatment.
3. Erectile Dysfunction: While rare, some patients may experience changes in erectile function following TUNA. It is essential to discuss any concerns about sexual health with a healthcare provider.
4. Prostate Abscess: In very rare cases, an abscess (a collection of pus) may form in the prostate after the procedure, necessitating further treatment.
5. Incontinence: Although uncommon, some patients may experience persistent urinary incontinence after TUNA. This risk is generally low and should be discussed with a healthcare provider.

While the risks associated with Transurethral Needle Ablation (TUNA) are generally low, it is essential for patients to have open discussions with their healthcare providers about any concerns. Understanding these risks can help patients make informed decisions about their treatment options and prepare for a successful recovery.
 

Recovery After Transurethral Needle Ablation (TUNA)

Recovery from Transurethral Needle Ablation (TUNA) is generally straightforward, with most patients experiencing minimal downtime. Immediately after the procedure, patients may be monitored for a short period to ensure there are no immediate complications. The expected recovery timeline can vary, but many patients can return to their normal activities within a few days.
 

Expected Recovery Timeline:

• First 24 Hours: Patients may experience mild discomfort, which can be managed with over-the-counter pain relievers. It’s common to have some blood in the urine, which should gradually decrease.
• 1 Week Post-Procedure: Most patients can resume light activities, such as walking or light household chores. Strenuous activities, heavy lifting, or vigorous exercise should be avoided during this time.
• 2 Weeks Post-Procedure: Many patients can return to their regular routines, including work, but should still avoid activities that may strain the pelvic area.
• 4-6 Weeks Post-Procedure: By this time, most patients will have fully recovered and can engage in all normal activities, including sexual intercourse.
   

Aftercare Tips:

• Drink plenty of fluids to help flush out the bladder and reduce irritation.
• Avoid caffeine and alcohol for at least a week, as these can irritate the bladder.
• Follow any specific instructions provided by your healthcare provider regarding medications and follow-up appointments.
• Monitor for any signs of complications, such as increased pain, fever, or persistent bleeding, and contact your doctor if these occur.
   

Benefits of Transurethral Needle Ablation (TUNA)

Transurethral Needle Ablation (TUNA) offers several significant benefits for patients suffering from benign prostatic hyperplasia (BPH). Here are some key health improvements and quality-of-life outcomes associated with the procedure:

1. Symptom Relief: TUNA effectively reduces urinary symptoms associated with BPH, such as frequent urination, urgency, and difficulty starting or stopping urination. Many patients report significant improvements in their urinary flow and overall bladder function.
2. Minimally Invasive: As a minimally invasive procedure, TUNA requires no large incisions, which means less pain and a lower risk of complications compared to traditional surgical options.
3. Quick Recovery: The recovery time is relatively short, allowing patients to return to their daily activities sooner than with more invasive surgeries.
4. Preservation of Sexual Function: Unlike some other treatments for BPH, TUNA has a lower risk of affecting sexual function, making it a preferred option for many men concerned about this aspect.
5. Outpatient Procedure: TUNA is typically performed on an outpatient basis, meaning patients can go home the same day, reducing the need for hospital stays.
6. Long-Lasting Results: Many patients experience long-lasting relief from their symptoms, with studies showing sustained improvement in urinary function for several years post-procedure.
    

Transurethral Needle Ablation (TUNA) vs. Alternative Procedure

While TUNA is a popular choice for treating BPH, it’s essential to consider other available options, such as Transurethral Resection of the Prostate (TURP). Below is a comparison of TUNA and TURP, highlighting their differences, pros, and cons.

Cost of Transurethral Needle Ablation (TUNA) in India

The average cost of Transurethral Needle Ablation (TUNA) in India ranges from ₹50,000 to ₹1,00,000. For an exact estimate, contact us today.
 

FAQs About Transurethral Needle Ablation (TUNA)

1. What should I eat before the TUNA procedure? 
   It’s generally recommended to have a light meal the night before your procedure. Avoid heavy, fatty foods and alcohol. Follow any specific dietary instructions provided by your healthcare provider.
2. Can I take my regular medications before the procedure? 
   Most patients can continue their regular medications, but it’s essential to inform your doctor about all medications you are taking. They may advise you to stop certain blood thinners or medications that could increase bleeding.
3. How long will I need to stay in the hospital after TUNA? 
   TUNA is typically an outpatient procedure, meaning you can go home the same day. However, you may need to stay for a few hours for monitoring.
4. What are the signs of complications I should watch for after TUNA? 
   Watch for increased pain, fever, persistent bleeding, or difficulty urinating. If you experience any of these symptoms, contact your healthcare provider immediately.
5. When can I resume normal activities after TUNA? 
   Most patients can return to light activities within a week and resume all normal activities, including work and exercise, within 4-6 weeks.
6. Is there a special diet I should follow after the procedure? 
   After TUNA, it’s advisable to drink plenty of fluids to help flush your bladder. Avoid caffeine and alcohol for at least a week, as they can irritate the bladder.
7. Can elderly patients undergo TUNA? 
   Yes, TUNA is suitable for elderly patients, but it’s essential to discuss any underlying health conditions with your doctor to ensure it’s safe.
8. Is TUNA safe for patients with other medical conditions? 
   TUNA is generally safe for patients with other medical conditions, but a thorough evaluation by your healthcare provider is necessary to assess individual risks.
9. How long does the TUNA procedure take? 
   The TUNA procedure typically takes about 30 minutes, but the total time spent at the facility may be longer due to pre-procedure preparations and post-procedure monitoring.
10. Will I need a catheter after the procedure? 
    Some patients may require a catheter for a short period after TUNA, but this is usually removed within a day or two.
11. What if I experience pain after the procedure? 
    Mild discomfort is common after TUNA. Over-the-counter pain relievers can help manage this. If pain persists or worsens, contact your healthcare provider.
12. Can I drive myself home after the procedure? 
    It’s advisable to have someone drive you home after the procedure, as you may still be feeling the effects of sedation or anesthesia.
13. How soon can I have sexual intercourse after TUNA? 
    Most patients can resume sexual activity within 4-6 weeks after the procedure, but it’s best to consult your doctor for personalized advice.
14. Are there any long-term side effects of TUNA? 
    TUNA has a low risk of long-term side effects, but some patients may experience mild urinary symptoms or changes in sexual function. Discuss any concerns with your doctor.
15. What follow-up care is needed after TUNA? 
    Follow-up appointments are essential to monitor your recovery and urinary function. Your doctor will provide specific instructions on when to return for a check-up.
16. Can TUNA be repeated if symptoms return? 
    Yes, if symptoms return after TUNA, your doctor may discuss the possibility of repeating the procedure or exploring other treatment options.
17. Is TUNA effective for all patients with BPH? 
    While TUNA is effective for many patients, individual results may vary. Your doctor will evaluate your specific condition to determine the best treatment approach.
18. What should I do if I have questions after the procedure? 
    If you have any questions or concerns after the procedure, don’t hesitate to contact your healthcare provider for guidance and support.
19. Can I take herbal supplements before or after TUNA? 
    It’s essential to discuss any herbal supplements with your doctor, as some may interfere with medications or the healing process.
20. What lifestyle changes can help improve my urinary symptoms? 
    Maintaining a healthy weight, staying hydrated, and avoiding bladder irritants like caffeine and alcohol can help improve urinary symptoms. Regular exercise and a balanced diet are also beneficial.
     

Conclusion

Transurethral Needle Ablation (TUNA) is a valuable option for men suffering from benign prostatic hyperplasia, offering significant symptom relief and improved quality of life. With its minimally invasive nature and quick recovery, TUNA is an appealing choice for many patients. If you are considering this procedure, it’s essential to speak with a medical professional to discuss your options and determine the best course of action for your health.