Prostiva RF Therapy, formerly known as Transurethral Needle Ablation of the Prostate, is a minimally-invasive treatment for men with urinary symptoms for prostate enlargement. It provides better improvement for urinary symptoms than medications with much less risk than traditional prostate surgery. The American Urological Association has this to say about treatments like Prostiva RF Therapy: “…there are now many acceptable alternatives to TURP (prostate surgery) that are less costly per treatment episode, that require less time to produce positive outcomes, and that have less associated morbidity (risk).”
Prostiva RF Therapy works by heating the enlarged, inner part of the prostate to very high temperatures, which results in shrinkage of the prostate and opening of the urinary channel. The Prostiva RF Therapy device is computer-controlled and uses radiofrequency energy to heat the prostate. The energy is delivered to the prostate by two needles that are deployed from the Prostiva RF Therapy device, a telescope which is inserted through the urethra into the prostate. The lining of the urethra is protected so that men have minimal bleeding or other side effects after the procedure. Most men start to notice improvement in their symptoms within 1-2 weeks after the Prostiva RF Therapy treatment and by 6 weeks 80% of men notice substantial improvement.
Who can benefit from Prostiva RF Therapy?
Prostiva RF Therapy was designed for men with prostate enlargement (BPH). It can help to improve the force of the urinary stream, improve bladder emptying, decrease the frequency and urgency to urinate, prevent urinary incontinence, and decrease the need to urinate at night. It is suitable for most men who have prostate enlargement, and is an alternative to using prescription medications such as Flomax or Uroxatral. Medications can give real improvement in prostate symptoms, but most men need to take the medications forever if they want long-term improvement. Some men choose Prostiva RF Therapy because they do not want to take medications or because the medications are too expensive or because the medications have undesirable side-effects. In addition, medications for erection problems such as Viagra, Levitra, or Cialis cannot be taken with some of the BPH medications. Prostiva RF Therapy is usually not suitable for men who have had previous prostate surgery, but this can be determined by the urologist. There are also some men with chronic prostate pain (chronic prostatitis) who benefit from Prostiva RF Therapy.
How is the procedure performed?
Prostiva RF Therapy is an office procedure which we perform at our Statesville office. Patients arrive early and are given oral medications for pain relief and sedation. A prostate ultrasound is performed in the office prior to the procedure to measure the exact size and shape of the prostate, and local anesthesia is injected to numb the prostate. The Prostive RF device is passed through the urethra and used to heat the inside of the prostate. The entire procedure lasts 30-60 minutes, and patients go home shortly after we are done. A catheter is left 1-4 days after the procedure. 90% of men urinate well when the catheter is removed, but some men will need to have the catheter replaced for several more days before normal voiding returns.
The long-term risks of Prostiva RF Therapy are very small, which is why it has mostly replaced TURP as the initial treatment for prostate symptoms. The risk of significant bleeding, urinary incontinence, or decreased erections is less than 1%. A small number of men (<5%) will notice decreased fluid when they ejaculate compared to 90% or more with TURP. Approximately 20% of men will not get adequate improvement from the Prostiva RF Therapy procedure and may require other treatments. The short-term risks after the procedure include burning with urination, frequent urination, slower urinary stream, urinary infection, or urinary retention. If any of these occur they are easily treatable and urination returns to normal within one week.
Patients will have a catheter 1-4 days after the procedure, depending on the prostate size and the severity of the urinary symptoms. For the first week after the catheter is removed patients may experience more increased urinary frequency and a slower stream than they had before the procedure. Men may also have a small amount of blood in the urine or burning with urination. After one week the urinary symptoms are back to normal and men then notice a slow, steady improvement in urinary symptoms over the next 3 months. By 6 weeks after Prostiva RF Therapy at least 80% of men notice significant improvement in their urination, and most can stop any BPH medications they were taking. All men will have blood in the semen for several weeks after Prostiva RF Therapy, but this causes no pain or other symptoms.