[MTG]

Has anyone had the TUNA Procedure? It is now called Prostiva. What was your experience like and did the procedure help with urine retention.

[interested]

I can't answer, but can add some information. My urologist began performing the Prostiva procedure about 1 year ago. He told me just last week that he has done about 60 so far, and that the results have been very good. About 80+% of these patients have stopped taking their BPH meds after about 3 months, and urological scores typically went from 19-20 down to 2-3. No long term data yet, although the manufacturer of the equipment states that it has 5 year data showing sustained improvement. Prior to last year, he was using Thermatrx (microwave) on his patients. One of them was me. It had zero effect for me: neither positive or negative -- except for the expense and discomfort of the procedure and recovery. In all, he said about 50% of Thermatrx patients showed some improvement (no quantifiable figures).

My understanding from him is that Prostiva is more effective because of the urologist's ability to control the depth of the RF administering needles (electrodes) into the prostate to provide better control of the amount of prostate tissue to be "killed" or ablated than microwave energy equipment can provide.

For me, I am sitting on the fence for whether to go for the Prostiva treatment. Things are not so bad that I need to hurry. Considering that I was "burned" before (no pun intended), I am leery of undergoing another treatment, even if the promise of positive results is there.

I would sure like to hear from others who have undergone the Prostiva treatment (Prostiva is a registered trademark for Medtronic, Inc.'s equipment, generically known as TUNA (trans uretha needle ablation).

[ploddingalong98]

I had the tuna procedure 5 weeks ago. I was pretty severe. I had to urinate multiple times to empty myself. My doctor has peformed hundreds of these minimally invasive operations.And, he has an impressive looking resume.

I couln't pee at all for two weeks after the operation. Now I can pee out more than 100cc's on my own, but I can't empty my bladder yet. I have to use a catheter 6 times a day. The doctor tells me that he thinks that I should improve in the next two months. I'm hoping that I at least get back to where I was before the operation, and don't need a catheter.

[interested]

First, let me tell you that I had the ThermMatrx procedure about 3 years ago. The improvement was zero. A total waste.

In June 2009, 6 months ago, I had the Prostiva procedure. I was dubious about it doing any good for me. The procedure went routinely. The urologist "blocked" the prostate by injecting a numbing drug into the prostate, much as a dentist does before doing his work. An anesthesiologist put me to sleep. No pain or discomfort after the procedure. Only the annoyance of the catheter and the bag, which I removed myself after 48 hours.

Within two weeks I began to observe noticeable improvement in my urine flow rate, which continued to slowly improve for a couple of months and then leveled off. I am now able to void quickly instead of standing over a bowl or urinal for minutes while I dribble. Also, periods of urgency have reduced by roughly 50%, but there are still times when the urge is very strong, such as after drinking a few ounces of wine, or being out in the cold, or drinking a lot of fluids when playing sports.

The number of trips to the bathroom overnight has remained pretty much the same for me, ranging from 2 to 5 and averaging around 3 or 4. Fortunately for me I am able to return to sleep rather easily.

I have been taking terozasin (Hytrin) for at least 1/2 dozen years for BPH. I plan to stop this drug therapy at the start of the new year in a couple of days. Even though this drug is used to treat BPH, it was originally developed to treat hypertension. I have been monitoring my blood pressure for a couple of weeks so that once I stop taking the drug I will be able to observe changes in both blood pressure and BPH symptoms.

Was having the Prostiva procedure a good choice? For me it was, and I would do it again. It offers improvement, but it is not the magic bullet. Prostiva opens the urethra channel for improved urine flow, but the prostate is still enlarged and presses on the bladder resulting in decreased bladder capacity.

[ploddingalong98]

Before the operation I referred to in my previous posting, my surgeon gave me the literature that indicated that the full effects of RF Prostiva happened with 6 to 12 weeks. But, I found the following on the web site of Johns Hopkins regarding TUNA or RF Prostiva:

"...In fact, you may notice no improvement in BPH for about two to eight weeks. This delay
in BPH symptom relief occurs because it takes time for the body to absorb and discard the
excess prostate tissue destroyed by the procedure."

"If TUNA is effective, you will experience its full benefits within three to six months..."

I hope that Hopkins is correct, (Rightly or wrongly I've always been impressed by Hopkins) because I need all the time I can get.

[ploddingalong98]

Update. It's been a little over 6 weeks since I had my RF Prostiva operation. I saw the doctor yesterday and he said I was doing well. (As I said before, I could urinate between 50 to 150 cc's without catheter). He surprised me and said he wants me to cut back to self cathing once a day. Since I have a one and a half hour commute both to and from work, I talked him into letting me self cath twice a day first. (I'm so used to self cathing after all these weeks that the change is a little or a lot scarey).

He said that if I cath less, I'll urinate more. he also thinks that the effects from the benefits are just starting to kick in a little.

Needless to say, I'm more positive on the operation right now than I was a week ago.

[ploddingalong98]

It's now almost 9 weeks since I had my Tuna procedure. I'm currently not using the catheter. I won't know how this is working out (not using the catheter) til my next appointment in 4 weeks. I'm still hoping to get back to where I was prior to the surgery. Although I had severe BPH symptoms, I never needed a catheter before the surgery. I'm still not sure that I'm seeing any benefits from the operation. I'm still getting up 5 times a night. But, I'm still hopeful. (My doctor says I may see benefits up to 12 weeks and Johns Hopkins says on their website up to 6 months). One effect I saw is that on rare occassions, I'm a little incontinent.

The doctor mentioned that if this doesn't work, I could have a turp. I think he was referring to the old fashioned turp. Thanks to Mr. Coyote, and research on the internet, I know that a green light PVP is a much better (less barbaric) way to go. I'm also going to ask my doctor about using flomax and avodart or proscar together. I read on the internet that that is the latest thing. If this doesn't work, my wife and I are not quite ready for me to go through another operation just yet. And, I occassionally wonder if I might have something wrong with me in addition to the prostate.

[ploddingalong98]

Based on my experience so far (10 weeks) with the Tuna procedure, I would recommend that no one with severe symptoms of BPH have this operation. If the Flomax is not helping you, this operation will probably not help you.

If the Flomax still helps you, and you have mild to moderately severe symptoms, this operation may be for you.

[ploddingalong98]

Almost 14 weeks since I've had the RF Prostiva procedure and I finally got some improvement and some actual straight talk from the doctor. My urine flow started improving about the 11th week after the operation. My doctor said he expected that. He said he used to schedule appointments with the patients at 1 month or 2 months after the procedure. But, he said he now schedules the first follow up appointment no sooner than 3 months after the operation. He said that it would be very unusual for any of his patients to have significant improvement until the 3rd month. Then he expects at least some improvement continuing until the 6th month. (Maybe its the way he does the procedure. But, Johns Hopkins web site, says something similar). And, I no longer seem to need the catheter for the last few weeks.

He said that we have to be realistic. I'm 59 and I probably won't have the urinary tract of a 12 year old or of a race horse. But, he said that the main thing is that I have significant improvement over how I was before the operation. But we'll have to wait until the 6 month point to see. This conversation has made me much more optimistic. But, I'll wait til 6 months to judge.

I also found out that there's no medical reason to avoid alcohol with an enlarged prostate. (See the results of a large international study on alcohol and BPH that I posted on another thread on this board). A glass of wine every evening has actually helped me some with my BPH symptoms. But, I think it can take several days to get used to the alcohol, if you haven't had it for a while, and too much alcohol is still bad for your organs.

[ploddingalong98]

16 weeks since I had the Tuna procedure. At this point I think the Tuna helped some, but not enough. At least not yet. My flow has improved, but not enough. After I finish urinating normally, I usually have to strain to get some additional urin out. Although, when I sit down and urinate I usually seem to get enough out, without straining, to feel empty.

He still wants me to wait the entire 6 months (9 more weeks) to see if I get more improvement. After the 6 months is up, if I'm in the same condition as now, I plan to tell him I want to try a combination of avodart and flomax. I'm also considering another operation.

But, I read that many men who have suffered from BPH for years have partially weak bladder muscles which prevent them from emptying their bladder completely without some straining. I'm wondering if this may be why the Tuna operation hasn't been completely successful so far. And, if I have partially weak bladder muscles, it seems like the TURP or Green Light PVP wouldn't be completely successful either. I don't think they work on the bladder muscles in those operations. So, I'm going to see if the Doctor can determine if I have partially weak bladder muscles efore deciding on having another operation.