2008 Annual Meeting Abstracts
Transurethral Needle Ablation of the Prostate For Men With Chronic Urinary Retention
Eric Lauer, Carl T. Reese, David Adams
Penn State Milton S. Hershey Medical Center, Hershey, PA
Introduction: While TURP is the gold standard for relief of urinary obstruction due to BPH, it cannot be offered to men who are poor surgical candidates. This is a retrospective review of 26 men with chronic urinary retention who underwent TUNA.
Methods: A retrospective chart review identified 29 patients who had undergone TUNA in our office from January 2004 through December 2006, three of whom were lost to followup. All of these patients were in chronic retention pre-operatively. The primary outcome assessed was ability to void spontaneously after TUNA. A secondary outcome was the effect of mean prostate size on a patient’s likelihood of voiding spontaneously after TUNA.
Results: Urinary retention was relieved in 17 of 26 patients post operatively (65%). The mean prostate gland size was larger in patients whose retention resolved after TUNA [mean=95.7 grams (SD=54.5)] as compared to patients whose retention did not resolve after TUNA [mean=77.7 grams (SD=64.2)]. This difference was not statistically significant [difference in means=18.0 grams; 95% CI (-37.0, 73.0); p-value=0.50]. Of patients whose prostate measured greater than 100 grams, 83% (5 of 6) were no longer in retention after TUNA, versus 62% (10 of 16) of those whose prostate was less than 100 grams. At a median follow-up of 8.5 months (25th percentile=3.6 months, 75th percentile=24.6 months), all of the patients whose retention resolved after TUNA continued to void spontaneously.
Conclusions: TUNA offers a minimally invasive, safe alternative to TURP for men in retention who are poor surgical canidates.
