Transurethral needle ablation (TUNA) of the prostate is minimally invasive treatment which uses heat to harden parts of the prostate tissue. This process is called coagulation. The treated part of the prostate is either absorbed by the body or it passes with urine after the procedure. The aim of TUNA is to reduce the prostate volume and to improve the symptoms.
When should I consider having TUNA?
TUNA is advised for men with a prostate between 30 to 80 millilitres, who prefer minimally invasive treatment or who are not fit to have surgery because of other medical conditions.
How is TUNA performed?
For TUNA you will receive intravenous, spinal, or local anaesthesia. Once you are under anaesthesia, the doctor enters your bladder through the urethra. The doctor uses an endoscope which has two needles and a camera. The needles are used to puncture the prostate and to heat up the tissue with radiofrequency energy (Fig. 1). This is done 4 to 8 times to treat the whole adenoma. The camera allows the doctor to see a high-quality image of the prostate on a video monitor.
You will need a catheter for some days until the urethra is healed and you can urinate on your own. The catheter is removed by the urologist at the hospital or clinic.
How to prepare
Your doctor will advise you in detail about how to get ready for the procedure. To prepare for the anaesthesia you should not eat, drink, or smoke for 6 hours before the procedure. If you are taking any prescribed medication, discuss it with your doctor. You may need to stop taking it.
After the procedure
How long will it take me to get back to my daily activities?
Usually, you can leave the hospital or clinic a few hours after TUNA. Do not drive a car when leaving the hospital because you may still be drowsy after the anaesthesia. Make sure you get enough rest on the day of the procedure.
With the catheter still in your urethra, you can start getting back to your daily activities the next day. Your urine may contain traces of blood which can last up to several weeks.
For 4-6 weeks after the surgery:
- Drink 1-2 litres every day, especially water
- Do not lift anything heavier than 5 kilograms
- Do not do any heavy exercise and avoid bike riding
- Do not take thermal baths or go to the sauna
- Prevent constipation by adapting your diet
- Discuss any prescribed medication with your doctor
Avoid having sex for 2-3 weeks. After TUNA, you may suffer from retrograde ejaculation. This is a chronic condition where semen can no longer leave through the urethra during orgasm. Instead it goes into the bladder and later leaves your body during urination. Your semen may be stained with blood for a few weeks.
You need to go to your doctor or back to the hospital right away if you:
- Develop a fever
- Face problems with the catheter
- Cannot urinate on your own after the catheter is removed