NEW BPH TREATMENTS
Transurethral Needle Ablation (TUNA)
Radio frequency energy can also be conducted through tiny needles, which are inserted directiy into prostate tissue via a special catheter. The needles can riddle the BPH tissue with holes of various sizes to weaken the tissue’s grip on the urethra. Experiments using TUNA in animals have been promising, and clinical trials of this technique are under way. The TUNA device is battery-operated, and may be among the least expensive of these techniques.
Pyrotherapy
This is the least invasive of these thermal therapies; in fact, there’s not even a probe to enter the body. Here’s how it works: Multiple ultrasound waves are focused at a single point some distance away from the power source. Only the concentration point, the target where all these beams intersect, is damaged. The cumulative energy of these waves, entering the body through a broad area, is great enough to cause thermal injury to BPH tissue and to create cavities in the prostate around the urethra. A prototype system (called Pyrotech) has been tested, and clinical trials are under way. However, it is not yet certain whether pyrotherapy will be able to pinpoint the prostate tissue surrounding the urethra as precisely as it needs to—entering the body either through the abdomen or perineum—because the bony pelvis gets in the way; this may turn out to be an insurmountable obstacle.
Cryotherapy
In this treatment, instead of heat, the opposite—extremely cold liquid nitrogen—is used to freeze and kill cells in BPH tissue. Guided by transrectal ultrasound, doctors circulate the freezing liquid nitrogen through three to five metallic probes, which are placed in the prostate gland through the perineum. A special catheter works like a hot water bottle to keep the urethra from freezing. There are no long-term studies to determine the effectiveness of this procedure.
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