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By Mayo Clinic staffTUNA takes less than an hour. It's usually done as an outpatient procedure, which means you will go home the day of the procedure.
You may be given an enema kit, which is used to clear your bowels and rectum at home, the morning of surgery. Shortly before your treatment, you will be asked to urinate so that your bladder is empty.
You'll be given a local anesthetic to numb the prostate area. The anesthetic may be inserted through the tip of your penis, or given in a shot via your rectum or in the area between your scrotum and anus (perineum).
You may also have intravenous (IV) sedation. With IV sedation, you'll be drowsy but remain conscious during the procedure. In some cases, spinal anesthesia or general anesthesia is used. With spinal anesthesia, you're numb from the waist down. With general anesthesia, you are unconscious during the procedure.
During the procedure
Once the anesthetic is working, a specially adapted visual instrument (cystoscope) is passed through the opening of your penis into your urethra. Your doctor will insert the cystoscope until it reaches the prostate area.
When the cystoscope is in place, your doctor will insert small needles into your prostate through the end of the cystoscope. Then, radio waves pass through them to heat and destroy prostate tissue blocking urine flow. You may feel a little pain or discomfort. The procedure generally takes about 45 minutes.
After the procedure
After TUNA, you'll have a catheter that extends through the tip of penis into your bladder. This allows you to pass urine until you can urinate on your own.
After the procedure, follow your doctor's instructions for recovery.
- Don't take blood-thinning medications until your doctor says it's OK.
- Don't do any strenuous activity, such as heavy lifting, for three to five days.
- Don't drive for the rest of the day after your procedure.
- Don't have sex until your doctor says it's OK. Most men can resume sexual activity after a few weeks.
Ask your doctor about any specific restrictions or other steps you need to take after the procedure. Your doctor may prescribe antibiotics to prevent infection and medications to reduce pain.
Side effects of TUNA can include:
- Blood in your urine (hematuria) for a few days after the procedure.
- Irritating urinary symptoms such as painful urination, difficulty urinating, or an urgent or frequent need to urinate. These symptoms usually improve within a week or so.
- Temporary difficulty urinating. A number of men have trouble urinating (urinary retention) after the procedure. If this happens, you may need to have a catheter in place for a few days. In some cases, a catheter is needed for a few weeks or longer.
- Urinary tract infection. Urinary tract infections are a possible complication after any enlarged prostate procedure. An infection is increasingly likely to occur the longer you have a catheter in place and may require antibiotics or other treatment. Some men have recurring urinary tract infections after TUNA.
- Fitzpatrick JM, et al. Minimally invasive and endoscopic management of benign prostatic hyperplasia. In: Wein AJ, et al. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/125743340-3/0/1445/91.html?tocnode=54305416&fromURL=91.html. Accessed Jan. 27, 2011.
- Guideline on the management of benign prostatic hyperplasia (BPH). Linthicum, MD. American Urological Association. http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines.cfm?sub=bph. Accessed Jan. 27, 2011.
- d'Ancona FC. Nonablative minimally invasive thermal therapies in the treatment of symptomatic benign prostatic hyperplasia. Current Opinion in Urology. 2008;18:21.
- Han M. Transurethral needle ablation of the prostate. In: Wein AJ, et al. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-7216-0798-6..50090-X--cesec17&isbn=978-0-7216-0798-6&type=bookPage§ionEid=4-u1.0-B978-0-7216-0798-6..50090-X--cesec17&uniqId=239958488-4#4-u1.0-B978-0-7216-0798-6..50090-X--cesec17. Accessed Jan. 2, 2011.
- Cunningham GR, et al. Surgical and other invasive therapies of benign prostatic hyperplasia. http://www.uptodate.com/home/index.html. Accessed Jan. 2, 2011.
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