One in eight men will be diagnosed with prostate cancer during their lifetime, making it the most common type of cancer for men after nonmelanoma skin cancer. Moreover, many men also suffer from benign prostatic hyperplasia (BPH), commonly known as enlarged prostate, which can cause urinary problems but is not cancerous. In the past, existing surgical options for prostate issues involved removing the entire prostate. Recently, certain less invasive procedures in which part of the prostate is removed, have become popular. Now, a groundbreaking minimally invasive option is available for qualifying patients at Windsong Radiology. The transurethral ultrasound ablation or TULSA procedure (TULSA-PRO) uses heat to destroy specific areas of prostate tissue, protecting healthy surrounding structures and helping to preserve functional abilities.
What Is the TULSA Procedure?
TULSA-PRO is an outpatient procedure cleared by the FDA in 2019. This procedure treats prostate cancer and enlarged prostate. The procedure uses directional thermal ultrasound to produce extremely high temperatures. This heat is used to ablate, or eliminate, localized areas of the prostate gland from the inside out. By removing tissue from inside the urethra outward to the edge of the prostate, the TULSA procedure protects nerve areas that control reproductive and urinary functions. This is a major benefit of the procedure. Traditional surgery can cause nerve damage resulting in erectile dysfunction and urinary incontinence.
To perform the robotically assisted procedure, which is done while the patient is under anesthesia, the interventional radiologist inserts a device called an ultrasound applicator into the urethra. The ultrasound applicator delivers heat energy to specific areas of the prostate while cooling mechanisms protect the urethra and the rectal tissue from being damaged by the heat.
The radiologist uses precise MRI guidance to view the prostate and draw boundary lines around sections of the prostate containing damaged or diseased tissue. Each section corresponds to individually controlled transducer elements, which deliver the heat energy. Once the radiologist has drawn the boundary lines, these areas are ready for ablation.
The radiologist sees the prostate at all times during the procedure, observing real-time temperature maps showing heat changes in and around the prostate. This allows for adjustments to be made as needed. The robotically driven TULSA-PRO system automatically follows the radiologist’s directions throughout the procedure, minimizing the risk of any errors.
Benefits and Risks
The TULSA procedure is fully customizable to each patient and can be performed in just one session, which generally takes a few hours. This leading-edge treatment plan offers many benefits:
- The ability to maintain or regain erectile and urinary functions after the procedure for the majority of patients, typically within three months
- Fast return to regular activities
- Minimal time spent in the hospital
- 95% reduction of prostate-specific antigen (PSA) levels in the blood (high PSA levels can indicate the presence of prostate cancer)
- 80% reduction in overall prostate size for patients with an enlarged prostate
Numerous trials have found positive outcomes for patients who have had the TULSA procedure. According to the Journal of Urology, a multicenter trial demonstrated effective prostate tissue ablation and PSA reduction with low rates of major side effects (toxicity, residual disease) after 12 months.
Who Is Eligible for TULSA?
Your doctor will determine if you are a candidate for TULSA-PRO. Patients of all ages can elect to have the procedure. However, every patient is evaluated individually to determine whether they qualify. In general, patients with cancer must have a low- to intermediate-risk prostate tumor that has not spread beyond the prostate. They must also have no history of calcium deposits in the prostate. Some patients with an enlarged prostate are also eligible. These factors are why a consultation is an essential step in the process.
When you have your initial consultation with a provider at Windsong, you’ll need to provide information from your doctor, such as:
- MRI information. This imaging test can determine the stage of cancer and help your doctor decide if further testing is necessary.
- Prostate biopsy report. A biopsy allows your doctor to examine prostate tissue if cancer is suspected.
- PSA score. If your doctor suspects prostate cancer, will likely order this blood test.
- Results of a digital rectal exam. In this exam, your doctor manually examines the prostate for any signs of cancer.
Your Windsong provider will evaluate your medical records and test results. They will then determine whether you are a good candidate for the TULSA procedure.
Leading-Edge Care
Windsong’s main campus in Williamsville, New York, is one of the few locations in the United States that offers the TULSA procedure. With accreditation from the American College of Radiology and our dedicated team of board-certified radiologists at Windsong, you can rest assured that you are receiving the highest level of care.
