Prostiva Therapy for BPH
Prostiva RF Therapy, formerly known as transurethral needle ablation of the prostate, is a minimally invasive, office-based treatment for men with urinary symptoms for prostate enlargement (symptomatic benign prostatic hyperplasia). Prostiva RF Therapy can improve urination by destroying excess prostate tissue, but also neutralizing the key messengers responsible for cellular growth in the prostate.
Prostiva utilizes radiofrequency (RF) technology, the movement of electron force that is manipulated to produce a targeted emission of heat. The office-based therapy takes less than an hour (with some additional preparation time required) and usually requires only local anesthesia.
The therapy provides better improvement than medications for urinary symptoms, cost savings over time, with much less risk than traditional prostate surgery.
Frequently Asked Questions
What Do I Need To Do Before The Procedure?
- Arrange transportation to and from treatment facility
- Let your physician know if you are taking any anti-coagulants (must stop 5-7 days prior to procedure)
- Take all of your regularly prescribed medications as directed by your urologist
- Bring your pre-procedure sedation medication with you to the office. You will be asked to take the medication once you arrive at the doctor's office. If you forget to bring it with you, you may need to reschedule your PROSTIVA RF Therapy procedure.
- Food should be eaten on the day of your procedure as instructed by your Urologist
- Please shower the morning of your procedure and wear comfortable, loose fitting clothes
- Decrease or eliminate you alcohol, caffeine and tobacco use 48 hours prior to procedure
- You may bring books, magazines or headsets with music to the facility
- Expect your visit to last 45-60 minutes, which includes preparation time, the procedure, and post procedure care. Average actual treatment time is 12 to 18 minutes.
What Will Happen During The Procedure?
You will lie back, sedated and comfortable. Your physician will pass the instrument through the urethra directly into the prostate. Two small probes deliver the RF energy to destroy the obstructive prostate tissue. The physician will likely treat several sites within your prostate. After one site is treated, your physician will move the instrument and probes to the next site and repeat the treatment until he determines he has treated enough sites to relieve your symptoms.
Is The Procedure Safe?
Yes, the procedure is safe. The instruments used in Prostiva RF Therapy contain several important safety features. For example, the device constantly measures temperature in the treatment area and automatically shuts off if it detects that it is getting too hot or if the pressure of the energy is too high or too low. Basically, the technology is designed to provide maximal awareness in order to facilitate accurate, optimal, and safe treatment.
What Will Happen After The Procedure?
After the procedure is complete, you may be asked to remain in the office until you urinate. If you are not able to urinate after the procedure, your doctor may elect to insert a catheter to ensure your comfort.
Catheterization is required only as needed, and when required, the duration is usually a maximum of two days. Prostiva RF Therapy was designed for use in an office, so you will not need to spend the night in a hospital. Most men go home the same day.
Upon arriving home, you should drink plenty of fluids. You should be able to return to most of your normal activities within 24 to 48 hours. There is minimal discomfort after the therapy. This can be relieved with over-the-counter pain medicines as needed.
You should relax and take it easy when you get home. You can expect optimal results in approximately six weeks; some patients may experience results sooner.
Will There Be Any Sexual Side Effects?
During the original clinical study conducted by Medtronic for the approval of this therapy, less than two percent of RF Therapy patients experienced impotence and less than one percent of patients experienced retrograde ejaculation.
What Side Effects Are Associated With Prostiva RF Therapy?
Possible side effects include obstruction, bleeding, blood in urine, pain/discomfort, urgency to urinate, increased frequency and urinary tract infection. Patients may also experience a minor burning sensation when urinating for one to two weeks following the treatment.
What Is The Risk Of Incontinence?
There were no reported cases of incontinence in the original clinical study conducted by Medtronic for approval of this therapy. In some other clinical studies, incontinence occurred in 3.1 percent of patients.
What Are The Benefits Of Prostiva RF Therapy?
Clinical studies have demonstrated that treatment with Prostiva RF Therapy for symptomatic BPH offers the following benefits:
- A procedure that takes less than an hour (with some additional preparation and recovery time required)
- Can be performed right in your Doctor's office
- Generally conducted with local anesthesia only
- This allows you to return to many of your normal activities within 24 to 48 hours
- Few side effects and adverse events when compared to traditional surgical treatment
- Few reports of incontinence
- Few reports of impotence
- Catheterization for up to two days
- Improvement within two to six weeks (however, results may vary depending on the severity, duration, and size of the prostate treated)
- Five-year durability
Is This A Recommended Treatment For BPH?
Yes, Prostiva RF Therapy for BPH is one of only a few minimally invasive treatments recommended by American Urological Association Guideline on Management of BPH.
Is Prostiva RF Therapy effective Long-term?
Yes. In a study published in 2004, data suggested that RF Therapy is effective and provides good long-term clinical improvement at a five-year follow-up. Only 14 percent of treated patients treated for this study required the more invasive transurethral resection of the prostate within a five-year span following Prostiva RF Therapy treatment.
Pre- and Post-Operative Instructions
Prior to your procedure
please adhere to the following instructions:
- No aspirin, ibuprofen (Advil, Motrin) or any other medication that might be considered blood thinners for seven days. Please read the label for precautions. This includes natural homeopathic medications as well. If you have any questions please ask your pharmacist, your primary care physician or your physician.
- No coumadin for five days prior to procedure. Please check with prescribing physician to be sure that you are able to be without medication. You can also ask the prescribing physician to call your urologist.
Day Of The Procedure
- It is permissible to eat a light meal before your procedure.
- Patient should arrive at the office at least one hour before the procedure to complete needed paperwork and for pre-operative medications.
- It is mandatory for the patient to have a designated driver to take him home after the procedure.
- Patients will usually go home with a Foley catheter connected to a leg bag for one to two days.
- Instructions will be given on the care of the catheter.
- Patient to take post op meds as instructed.
- Appointment to be made for return visits in 1-2 days to remove catheter and have a voiding trial.
- If unable to void, catheter will be reinserted and a follow-up appointment will be made for 5-7 days for another voiding trial.
- Post Prostiva office visits with the MD in two weeks and 6 weeks need to be scheduled for uroflow and PVR checks.
- If you have any questions or concerns, please call the triage nurse.
For more information about Prostiva go to www.medtronic.com