Prostiva RF Therapy (Transurethral Needle Ablation): Evaluation of Results from 127 Patients

Abstract

Aims of Study

Following the latest guidelines, management of LUTS/BPH includes not only conventional prostatic surgery, but also the minimally invasive treatment (MIT) of symptoms, with great attention given to improvement in the quality of life. One such MIT for BPH is the Prostiva RF Therapy (Transurethral Needle Ablation). The aim of the study was to evaluate the results obtained from 127 patients (pts) treated with Prostiva.

Materials and Methods

The Prostiva RF Therapy is a MIT indicated in the treatment of BPH<50 gr with no median lobe and with PSA inside normal limits. This procedure employs low-level radio frequency energy delivered from a generator. From October 2004 to January 2009 120 pts (mean age: 64 years) were treated with Prostiva RF Therapy at two Italian centers. International Prostate Symptom Score (I-PSS), Quality of life (QoL) and Index of Erectile Dysfunction (IIEF5) were compared between baseline and last follow-up.

Results

Mean FU was 27 months ± 24. At baseline, the mean prostate size was 36.62±16 gr. At enrollment, 70 of 120 pts (58%) were under pharmacological treatment for BPH. 102 pts were treated under spinal anesthesia and 18 under local anesthesia. The total average time of the procedure was 28’. The average number of ablations was 5. Uroflowmetry showed a significant improvement in 67% of pts. 63% reported overall satisfaction with I-PSS and QoL improvement. 25% pts needed further therapies (15% pharmacological, 10% TURP). There were no serious complications, 12% needed prolonged catheterization (max 7 days), 6% experienced transient irritation (max 2 weeks), 5 pts experienced transitory ejaculation disorders, and 1 pt anejaculation. There were no significant differences in IIEF -5 either before or after the procedure.

Conclusions

In our experience the PT was effective in 66% of treated patients. The procedure was easy, safe and feasible to be carried out under local anesthesia.

Keywords

TUNA (Trans Urethral Needle Ablation)BPH (Benign Prostatic Hyperplasia)Cervicourethral obstruction LUTS (Lower Urinary Tract Syndrome)Ejaculation IPB (Ipertrofia Prostatica Benigna)Ostruzione cervico-uretrale Eiaculazione

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