What Is the Ideal BPH Treatment?

• Single Event

• Office Procedure

• Painless

• No Morbidity

• No Work Time Lost

• Efficacious

• Durable

	TUNA®	Laser	Microwave	TURP
Single Event	3	3	2	3
Office	3	0	3	0
Painless	2	0	2	0
No Morbidity	2	1	1	1
No Work Lost	3	1	2	0
Efficacious	3	3	2	3
Durable	3	3	1	3
TOTAL	19	11	13	10

Treatment Options

Treatment choices include:

• Drug Therapy
• Radio frequency (TUNA)
• Laser coagulation (ILC)
• Microwave therapy (TUMT)
• Surgery (TURP)
  

Drug Therapy

Side effects can include impotence, dizziness, headaches and fatigue. Additionally, the body sometimes becomes resistant to the drugs and they lose effectiveness over time. Most recently herbal (plant) extracts, such as saw palmetto, have been used to relieve BPH symptoms. Although the clinical data is limited, these agents may produce small degrees of improvement, but they do not reduce the size of the prostate. Additionally, these agents may reduce PSA levels, important indicators within the body which may indicate the presence of cancer.

Minimally Invasive Treatments

TUNA - TransUrethral Needle Ablation

The TUNA procedure delivers low level radio frequency (RF) energy to the prostate, relieving obstruction without causing damage to the urethra. A small catheter is inserted through the urethra and into the prostate. Two small electrodes are deployed and using a computerized generator to monitor temperature and treatment zones, RF energy is emitted, causing the prostate tissue to shrink, thereby relieving the obstruction while protecting the urethra and surrounding areas.

The TUNA procedure can be performed in an office or hospital outpatient center in less than 1 hour using minimal anesthesia. Catheterization is needed in about 40% of the patients--on average less than 2 days. Most patients are able to return to their normal activities within 24 hours. There are minimal side effects, including few reports of sexual dysfunction. The TUNA procedure is reimbursed by Medicare in most states as well as by many private pay and managed care insurance companies.

Interstitial Laser Coagulation - ILC

ILC uses laser energy to coagulate excess tissue of the prostate. This targeted heating produces coagulative tissue necrosis, with the tissue resorption occurring gradually over time, reducing obstruction. The laser energy is delivered consistently through interstitial tissue with a diffusing tip fiber optic, reducing the risk of damage to adjacent structures.

The procedure can be performed in less than 1 hour in a hospital outpatient center using a variety of anesthesia types. In the clinical trials sponsored by Indigo Medical, 83% of the patients required general or spinal anesthesia. Because of the edema caused by the procedure, catheterization is highly recommended, with most patients averaging 7-14 days. Procedure risks include urinary tract infections, retention, incontinence, and retrograde ejaculation.

Transurethral MicrowaveTherapy - TUMT

TUMT uses high temperatures to heat and destroy the prostate tissue, with cooling to keep adjacent healthy tissue intact. Microwave energy is delivered through a soft probe, resulting in destruction of diseased tissue and a reduction in BPH symptoms.

TUMT can be performed in a hospital outpatient center in over 1 hour and requires minimal anesthesia. Catheterization time ranges from 2-5 days and may result in urinary tract infections. Risks and complications include retrograde ejaculation, urethral strictures, urinary retention, and incontinence.

Surgery

TransUrethral Resection of the Prostate - TURP

TURP is an invasive surgical procedure that has been in practice for more than fifty years. TURP has been considered the "gold standard" of treatment, to which alternative therapies are compared. This procedure usually takes about 1 hour. A cutting loop is used to remove the obstructing tissue. Each year, fewer TURPs are performed, as less invasive technologies emerge.

As with any surgery, there is risk involved. Not all patients are surgical candidates, the procedure is costly, and generally requires a patient to remain hospitalized for 1-4 days. General or spinal anesthesia is required, and recovery can take 4-6 weeks. Complications and risks include excessive blood loss, impotence, retrograde ejaculation, incontinence, and infection.

Choosing a Treatment Plan