title: Transurethral needle ablation versus transurethral resection of the prostate for the treatment of symptomatic benign prostatic hyperplasia: 5-year results of a prospective, randomized, multicenter clinical trial.
abstract: OBJECTIVE
  We report the 5-year efficacy and safety of transurethral needle ablation of the prostate (TUNA) compared to transurethral resection of the prostate (TURP) for the treatment of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH).
  
  
  METHODS
  A total of 121 men 50 years or older with LUTS secondary to BPH a minimum of 3 months in duration were enrolled in this prospective, randomized clinical trial at 7 medical centers across the United States. Of the participants 65 (54%) were randomly selected to receive TUNA and 56 (46%) were selected to receive TURP. International Prostate Symptom Score, quality of life, peak urinary flow rate, post-void residual urinary volume, and prostate size and configuration were evaluated before the procedure and then annually for 5 years after the procedure. Adverse events were also recorded throughout the study.
  
  
  RESULTS
  Improvement from baseline for TUNA and TURP retained statistical significance at each interval for International Prostate Symptom Score, quality of life and peak flow rate. Post-void residual volume was statistically significant at all time points for TURP and at year 5 for TUNA. The TURP group reported 41% retrograde ejaculation, while the TUNA group reported none. The incident of erectile dysfunction, incontinence and stricture formation was also greater in TURP than in TUNA cases with significantly fewer adverse events for TUNA than for TURP.
  
  
  CONCLUSIONS
  The results of this study demonstrate stable treatment outcomes after 5 years of followup and suggest that TUNA is an attractive treatment option for men with LUTS due to BPH.
authors.affiliation: Division of Urology, University of Maryland School of Medicine, Baltimore, Maryland, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Hill
authors.forename: William
authors.initials: W
authors.lastname: Belville
authors.forename: Reginald
authors.initials: R
authors.lastname: Bruskewitz
authors.forename: Muta
authors.initials: M
authors.lastname: Issa
authors.forename: Ramon
authors.initials: R
authors.lastname: Perez-Marrero
authors.forename: Claus
authors.initials: C
authors.lastname: Roehrborn
authors.forename: Martha
authors.initials: M
authors.lastname: Terris
authors.forename: Michael
authors.initials: M
authors.lastname: Naslund
mesh_terms: D000368:Aged; D017115:Catheter Ablation / Q000379:methods*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011470:Prostatic Hyperplasia / Q000601:surgery*; D013997:Time Factors; D020728:Transurethral Resection of Prostate; D014521:Urethra