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While the choice of procedure in benign prostatic hyperplasia is dependent on size of prostate, bladder neck problems, symptoms and severity of them, age, associated co-morbid conditions, physician and patient's preference, so no procedure can be considered over all superior to other. Pros and cons of both the procedures is mentioned;
1) Transurethral needle ablation (TUNA) is offered as one of the less-invasive surgical treatment modalities.
2) TUNA can be performed in an outpatient or clinic setting with local anesthesia and oral sedation.
3) The cost is less in terms of the direct cost of the procedure and recovery time.
4) The intra operative and postoperative morbidity and mortality rates are significantly lower with TUNA.
5) TUNA is associated with fewer sexual side effects and less bleeding.
The long-term outcomes may not be durable of TUNA.
KTP greenlight Laser:
1) Bleeding is insignificant.
2) Done as out-patient basis and the patients are discharged on the same day.
3) The urinary catheter may need to be kept for just a few hours.
4) If the patient is on blood thinning medicines, procedure can be done without stopping anticoagulants, if adequate precautions are taken.
5) An advantage of this technique is that it can be offered to anyone regardless of age, symptoms, configuration of the prostate, or severity of symptoms.
6) Patients do not experience any adverse effect on potency.
7) The procedure can be performed with a regional or local anesthesia.
Can't be done in patients in whom coagulopathies that are not reversible
Active infections if present, procedure can't be done.
Prostates larger than 80 gms, not helpful.
Tissue for biopsy and histopathological examination may not be available.
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