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New Minimally Invasive Office Procedure (“T.U.N.A.”) for the Treatment of BPH
Benign prostatic hyperplasia, or BPH, affects more than eight million American men in the United States and usually begins in the fourth decade of life with significant symptoms present in one-fourth of me by age 70. History, physical examination, bladder scanning for post-void residual urine and occasionally urodynamic evaluation all contribute to the effective diagnosis of BPH.
Symptoms of BPH are divided into two categories – obstructive and irritative. Obstructive symptoms include: weakness of urinary stream, hesitancy, terminal dribbling, intermittency, sensation of incomplete bladder emptying and straining to urinate. Irritative voiding complaints include: urinary urgency, frequency, nocturia and occasionally incontinence. In addition to significant symptoms, BPH can result in the development of urinary tract infections, bladder stones, urinary retention, chronic renal insufficiency and/or renal failure. Many of these symptoms respond to treatment if diagnosed early, although renal failure may be irreversible.
Primarily, the severity of symptoms direct the need for treatment. Patients with moderate to severe symptoms require intervention, medical or surgical. Medical treatment includes alpha receptor blocking agents to relax the bladder neck and prostatic smooth muscle, such as tamsulosin (FlomaxTM), terazosin (HytrinTM) or doxazosin (CarduraTM). Finasteride (ProscarTM) typically can shrink the prostate gland by approximately 25 percent over a 3 to 6 month period. Additionally, may herbal products such as saw palmetto and others are available, but lack FDA approval for increased efficacy.
When medication fails to decrease symptoms and post-void residual urine, other forms of therapy are entertained. Transurethral resection of the prostate (TURP) remains the standard in the treatment of symptomatic BPH. Although a relatively safe surgical procedure, TURP usually requires an overnight hospital stay and has potential intra-operative and post-operative risks.
Transurethral Needle Ablation of the prostate, also known as “T.U.N.A.” is an innovative approach for the treatment of BPH. This minimally invasive, office based procedure involves the use of low-level radio frequency energy to shrink the prostate, thereby relieving the intra-urethral obstruction. “The procedure usually can be performed in less than on hour in the office with minimal local anesthetic required,” says Dr. Steven Roth of Tri-County Urologists. Most patients return to normal activity within 24 hours and notice consistent improvement over the following 6 to 12 weeks. Tri-County Urologists in its dedication to total urologic care is pleased to offer the new FDA approved treatment.
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