Prof. Dr. Emel Akoğlu
UrologyVerified
- 57+years exp.
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Prostate
Tuna (transurethral needle ablation)
What TUNA is, how radiofrequency needles heat and shrink obstructing prostate tissue, what the evidence says and why newer methods have overtaken it, who it still suits, how it compares with TURP, TUMT and Rezum, approximate costs in Turkey against the UK, US and Germany, recovery, risks and how to check a clinic.
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Verified surgeons for TUNA (Transurethral Needle Ablation)
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Prof. Dr. Zerrin Biçik Bahçebaşı
UrologyVerified
- 37+years exp.
English · Turkish
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What is TUNA (transurethral needle ablation)?
TUNA (transurethral needle ablation) is a minimally invasive treatment for urinary symptoms caused by an enlarged prostate (benign prostatic hyperplasia, BPH). A slim instrument is passed along the urethra to the prostate, and two tiny needles are pushed out from it into the gland on each side. Low-level radiofrequency energy travels through the needles and heats the targeted tissue to well above body temperature, while a protective shield keeps the urethral lining cool. The heated tissue dies, is slowly absorbed by the body, and leaves a small scar; the gland softens and the channel for urine widens a little. There is no cut, no tissue is taken out, and the treatment takes roughly 30 to 45 minutes.
This guide explains how TUNA works, what the evidence says, who might still consider it, how it compares with other prostate procedures, what it costs in Turkey against the UK, US and Germany, and what recovery involves. The full range of prostate and bladder treatments is on our urology treatments in Turkey page.
How do radiofrequency needles shrink the prostate?
An enlarged prostate narrows the urethra and causes a weak stream, hesitancy, frequent urination and night-time trips to the toilet. In TUNA, the surgeon watches through a lens in the instrument and places the needles into the areas that squeeze the urethra, usually the lateral lobes. The needle tips heat a small zone of tissue; the shield, which is placed against the urethral wall, stops that wall from being burnt. Several zones may be treated in one session, with each lasting a few minutes. Over the next weeks to months, the dead tissue shrinks and the nerve fibres that tighten the prostate are damaged. The improvement therefore builds slowly instead of appearing immediately, and a catheter is often needed for a short time while swelling settles.
Does TUNA work, and is it still recommended?
Studies show that TUNA improves symptom scores and urine flow compared with sham treatment, with less bleeding and fewer sexual side effects than TURP. However, the improvement is smaller than after TURP and the longer-term data show that a significant share of men need further treatment within several years. Because newer, more durable options exist, TUNA has fallen out of favour in many countries and several guidelines no longer recommend it or list it only for selected cases, so the equipment is not available everywhere. This is worth knowing before travelling: ask the hospital how often it performs TUNA, why it suggests it rather than steam therapy, laser or TURP, and what it will do if the result is not enough. A trustworthy clinic will describe its limits plainly and will not promise a permanent cure.
Who may be suitable for TUNA, and who is not?
TUNA was designed for men with moderate symptoms and a small to medium prostate who prefer to keep ejaculation, who dislike the idea of an operation under anaesthesia, or who are not fit for surgery. It is a poor choice if the prostate is very large, if there is a prominent middle lobe protruding into the bladder, if you have a urinary infection, bladder stones or unexcluded prostate cancer, or if the problem is a weak bladder muscle rather than obstruction. Before any treatment, a good urologist should check symptom scores, a urine flow test, post-void residual volume, a PSA discussion and an ultrasound or cystoscopy. Men who are taking medicines such as alpha-blockers or 5-alpha reductase inhibitors should also discuss whether these might be enough.
TUNA, TUMT, Rezum or TURP: how do they compare?
These are the main alternatives a urologist may mention for an enlarged prostate.
| Procedure | Best suited to | Typical limits |
|---|---|---|
| TUNA | Small to medium prostates; men wanting to avoid anaesthesia and keep ejaculation | Modest, slower improvement; repeat treatment more likely; limited availability |
| TUMT | Similar patients, heat from microwaves | Longer catheter period; also less durable than surgery |
| Rezum steam therapy | Medium prostates, preserving sexual function | Catheter for days to weeks; evidence mainly from newer trials |
| TURP | Most prostate sizes, the strongest and longest-lasting relief | Anaesthesia needed; bleeding and retrograde ejaculation risk |
Compare with TUMT and Rezum water vapour therapy, both also heat-based, or with TURP, the long-standing surgical standard. For small glands, TUIP is a further option.
How is TUNA performed step by step?
TUNA is usually a day-case procedure, performed with local anaesthetic gel in the urethra, often with sedation or spinal anaesthesia, depending on the hospital. A typical sequence is:
- A urine test is done to exclude infection, and you may be given antibiotics.
- You lie on your back; the instrument is passed along the urethra and the prostate is inspected through the lens.
- The needles are deployed into the prostate, and radiofrequency energy is delivered at each site, with the temperature and time monitored.
- The needles are retracted and moved to the next site until the planned areas are treated.
- A catheter is placed for a short time, often one to a few days, though some men leave without one.
Most patients walk out the same day or after one night, once they are comfortable and passing urine.
TUNA (transurethral needle ablation) cost in Turkey compared with the UK, US and Germany
The figures are approximate ranges for the procedure with a short stay, not hospital quotes. Prices vary with the device, sedation, the hospital and the number of treated sites, and the cost is lower than surgery because it is generally a day-case.
| Country | Approximate cost range |
|---|---|
| Turkey | €1,300 – €4,000 |
| United Kingdom | €2,500 – €6,000 |
| United States | €4,000 – €10,000 |
| Germany | €2,000 – €5,000 |
A package normally covers the consultation, flow tests and ultrasound, the treatment, sedation, catheter and medicines, plus a follow-up check. Since TUNA is not offered by every hospital, ask whether the price assumes your gland is a suitable size and what the plan is if another treatment is better. A written plan through our free quote page lets you compare these points.
Recovery after TUNA: what to expect
Recovery is usually quick, but the benefit appears slowly. A realistic timeline:
- Day 0: treatment, rest and a catheter if used; mild burning and blood-tinged urine are common.
- Days 1 to 3: catheter removal and discharge once you pass urine comfortably.
- Week 1 to 2: urgency, frequency and burning can be worse for a short time; drink plenty of water and avoid heavy lifting and long cycling.
- Weeks 3 to 6: swelling falls and urine flow starts to improve; light exercise resumes.
- Months 2 to 3: the main benefit is judged, usually with a repeat flow test.
Most visitors stay three to five nights so the catheter is out and urine flows before the flight. Because the improvement is gradual, arrange a follow-up with a urologist at home; the hospital can send a report.
Risks and side effects of TUNA
Common effects include blood in the urine or semen, burning on urination, urgency, frequency and a temporary difficulty passing urine, which is why a catheter may be needed for a few days. Urinary tract infection occurs in a minority of men and is treated with antibiotics. Compared with TURP, retrograde ejaculation and erectile problems are less frequent, although a small number of men report changes. Rare risks include urethral injury or stricture, and symptoms returning, which may need a second treatment or surgery. NHS information and urology societies advise that any procedure should follow a proper assessment and exclusion of cancer. Seek medical help for fever, heavy bleeding with clots or an inability to pass urine.
How to choose a urologist and hospital, and questions to ask
Look for a urology department that performs several prostate treatments and has current TUNA equipment and experience, since the technique is less widely used than before. Red flags are a recommendation without a flow test or ultrasound, guarantees of permanent relief or of no side effects, no discussion of alternatives and no plan for follow-up. Read how our process works and ask:
- How many TUNA treatments does the hospital do each year?
- Why is TUNA better suited to my prostate than Rezum, laser or TURP?
- What is the chance that I will need further treatment?
- Will I have a catheter, and for how long?
- Who reviews my symptoms and flow when I return home?
Hospitals with Urology in Turkey
Frequently asked questions
TUNA is a treatment for an enlarged prostate in which two fine needles, passed through the urethra, deliver radiofrequency heat to obstructing tissue. The treated tissue shrinks over weeks, with no cut and no tissue removed.
It improves symptoms and flow compared with a sham treatment, with fewer side effects than surgery. The improvement is smaller than after TURP and a good share of men need further treatment later, so expectations should be modest.
It is used less than in the past because newer, more durable treatments exist, and some guidelines no longer recommend it. Ask whether the hospital offers it regularly and why it suggests it for you.
Approximate ranges are €1,300 to €4,000 in Turkey against about €2,500 to €6,000 in the UK. The price depends on the device, sedation and follow-up, and a written quote shows what is included.
Local anaesthetic gel, sedation or spinal anaesthesia is used. Afterwards expect burning on passing urine, urgency and some blood in the urine, usually settling within one to two weeks.
Most men go home the same day or after one night and return to light work within a few days. Heavy lifting is avoided for about two weeks, and flow improves over two to three months.
Often yes, for a day or a few days while swelling settles, although some men go without one. The hospital will say how it manages this.
TUNA avoids heavy anaesthesia and most bleeding and ejaculation problems but gives a smaller, slower improvement with a higher chance of repeat treatment. TURP is more effective and lasts longer.
Retrograde ejaculation and erectile problems are less common than after TURP, but a few men notice changes. Discuss your priorities with the urologist before choosing a treatment.
Three to five nights are usual so the catheter is out and you pass urine comfortably before flying. The urologist decides when it is safe to travel and plans follow-up at home.
Patient stories