Procedure Transurethral Needle Ablation (TUNA) and Hospitalization of Short Duration (EPURE)

Evaluation of Procedure Tuna Within the Framework of a Hospitalization of Short Duration

The TUNA is a known and already old technique. There exists, in the literature, a certain number of studies showing the long-term effectiveness (5 years), evaluated on the IPS and the flow mictional.This effectiveness is slightly lower than that of the endoscopic resection of prostate. This technique does not present the disadvantages of the surgery prostate sufferer on ejaculation. Moreover, it can be carried out in short hospitalization or ambulatory as it is the case in particular in the States Unis. The aim of the study which will be led by the AP-HP will be thus to test the feasibility of the TUNA during a hospitalization of less 24 hours.

Study Overview

• Status: Completed
• Conditions: Benign Prostatic Hyperplasia
• Intervention / Treatment: Procedure: Transurethral Needle Ablation (TUNA)

Detailed Description

The TUNA is a known and already old technique. There exists, in the literature, a certain number of studies showing the long-term effectiveness (5 years), evaluated on the IPS and the flow mictional. This effectiveness is slightly lower than that of the endoscopic resection of prostate. This technique does not present the disadvantages of the surgery prostate sufferer on ejaculation. Moreover, it can be carried out in short hospitalization or ambulatory as it is the case in particular in the States Unis. The aim of the study which will be led by the AP-HP will be thus to test the feasibility of the TUNA during a hospitalization of less the 24h.

Objective one: To test the feasibility of a procedure TUNA at the time of a hospitalization of less 24h.

Number of patients: A sample of N=70 patients will make it possible to estimate the frequency of success with a precision of ± 10% for any frequency higher than 75%.

Analyse statistical: Principal analyze: Count held of the aim of the study the principal analyses will be descriptives. For the variables qualitative or semi-quantitative bilateral the confidence frequencies and their interval at 95% (IC95) will be presented. If the conditions of use of the asymptotic estimators would not be filled, of the exact estimators will be used. For the quantitative averages and IC95%, median variables and outdistances interquartile will be calculated. Together analyses will be presented for the general population and by center.

Secondary analyze: In case of rate of important failure, an exploratory analysis at end of identification of the predictive factors of failure will be made by analysis in multivariate logistic regression.

Awaited results: The precise evaluation carried out by the present study will make it possible to evaluate the benefit report/ratio risks in the short run procedure and its feasibility within the framework of a hospitalization in surgery ambulatory. The implications are important. Indeed, if this technique can be done into ambulatory with a high rate of success, then this technique of treatment could be proposed in alternative of the medical treatment or to the bad responders with the medical treatments.

• Study Type: Interventional
• Enrollment (Actual): 53
• Phase: Not Applicable

Contacts and Locations

Study Locations

• France
  • Paris, France, 75020
    • Hôpital Tenon - Service d'Urologie

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 41 years to 81 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Male

Description

Inclusion Criteria:

1. Man whose age is superior or egal to 45 and inferior or egal to 85 years
2. Patient presenting an anaesthetic risk of ASA 1 at 3
3. Patient accepting the protocol, in particular the return to residence with a sounder

4. Patient presenting a TUBA related to a HBP and lasting since more than 3 months

   1. with a gene score higher superior or egal to 3
   2. with a score IPS superior to 8
5. Patient presenting a prostate whose estimated weight is inferior or egal to 80g, without median lobe prevailing and whose transverse width lies between 34 and 80 mm.
6. Patient having a residue post mictional lower than 200cc.
7. Patient presenting a normal renal function
8. Patient having a result PSA £ 4 ng/ml, or negative biopsies if PSA > 4 and < 10 ng/ml
9. Patient having given his free and in writing lit assent
10. Patient affiliated to the Social security or an assimilated mode
11. Patient having stopped his treatment by 5 alpha reductase since at least a month (1)

Exclusion Criteria:

1. Patient presenting a urinary infection
2. Patient presenting an acute retention of urine
3. Patient presenting a neurological bladder and/or of an anomaly of the sphincter
4. Patient currently under anticoagulant treatment.
5. Patient currently under anti-inflammatory treatment.
6. Patient presenting an affection or a confirmed or suspected malignant tumour of the prostates or vegie.
7. Patient presenting an antecedent of surgery prostatic
8. Patient presenting of the biopsies prostate sufferers carried out less than 4 months before procedure TUNA
9. Patient introducing of the antecedents of vesical lithiasis, haematuria important, contracting of the urethra, stenosis of the vesical collar, pathologies of the bladder or sweetened diabetes affecting vesical operation,
10. Patient presenting a prosthesis in the zone being able to be affected by the procedure
11. Patient presenting a desire of fertility
12. Patient presenting an anorectal pathology
13. Patient presenting an allergy to the anaesthesia locale
14. Patient whose follow-up seems incompatible with the needs for the study

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Non-Randomized
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: Procedure TUNA	Procedure: Transurethral Needle Ablation (TUNA); Transurethral needle ablation of benign prostatic hyperplasia by radio frequencies; Other Names: radiofrenquency prostate

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Left the hospital	the evening of the intervention
Not hospitalized for a complication related to the intervention	in the month following the intervention

Secondary Outcome Measures

Outcome Measure	Time Frame
Evaluation of the satisfaction of the intervention for the patient	at 1 month
Evaluation for the micturition of the following parameters	at 1 month
Evaluation of the appeared minor complications	at 1 month

Collaborators and Investigators

• Sponsor: Assistance Publique - Hôpitaux de Paris
• Investigators: Principal Investigator: Bertrand LUKACS, MD,PhD, Assistance Publique - Hôpitaux de Paris

Study record dates

Study Major Dates

• Study Start: March 1, 2006
• Primary Completion (Actual): December 1, 2008
• Study Completion (Actual): March 1, 2009

Study Registration Dates

• First Submitted: April 29, 2009
• First Submitted That Met QC Criteria: April 29, 2009
• First Posted (Estimate): April 30, 2009

Study Record Updates

• Last Update Posted (Estimate): October 1, 2009
• Last Update Submitted That Met QC Criteria: September 30, 2009
• Last Verified: April 1, 2009

More Information

Terms related to this study

• Keywords: Radiofrequency; Outpatient treatment; Mini invasin surgery; Men health
• Additional Relevant MeSH Terms: Pathologic Processes; Prostatic Diseases; Prostatic Hyperplasia; Hyperplasia
• Other Study ID Numbers: P050302