Transurethral needle ablation of the prostate: an initial Japanese clinical trial.
OBJECTIVE
Transurethral needle ablation of the prostate is a new alternative endoscopic thermal therapy that uses a low-energy radio frequency delivered into the prostatic adenoma. Herein is reported the initial clinical experience by multiple institutes in Japan of transurethral needle ablation of the prostate for the treatment of symptomatic benign prostatic hyperplasia.


METHODS
A total of 93 patients were treated with this technique. Transurethral needle ablation of the prostate was generally performed under low-spinal anesthesia. Before and after the procedure, international symptom score (IPSS), quality of life (QOL) score, peak urinary flow rate (Qmax), postvoid residual urine volume and prostate size were evaluated.


RESULTS
There was a reduction of IPSS of more than 50% when compared with that of pretreatment, being 51.3% (57/93 patients) and 60.2% (56/93 patients) at 3 months and 6 months after the procedure, respectively. Sixty-seven patients who were available for a 12-month follow-up period demonstrated a markedly decreased mean IPSS when compared with that measured before the treatment for a statistically significant difference (P < 0.01). Fifty-eight patients who were available for uroflowmetric study at 12 months exhibited a notably increased mean Qmax of 11.2 +/- 4.5 mL/s, which was a statistically significant increase when compared with that found before treatment (P < 0.05). Although all patients suffered some degree of gross hematuria after the procedure, none of them required any specific treatment for complications.


CONCLUSIONS
Transurethral needle ablation technique for the treatment of symptomatic benign prostatic hyperplasia is safe and effective. However, a much longer follow-up study is essential for fully evaluating the extended effectiveness of this technique.
Departments of Urology, School of Medicine, Keio University, Tokyo, Tokyo Medical University, Tokyo, and Nara Medical University, Nara, Japan. mmurai@med.keio.ac.jp
M
M
Murai
M
M
Tachibana
M
M
Miki
H
H
Shiozawa
Y
Y
Hirao
E
E
Okajima
D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009339:Needles; D011470:Prostatic Hyperplasia / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D011788:Quality of Life; D014521:Urethra; D014563:Urodynamics