ULTRASOUND ABLATION OF THE PROSTATE WITH A HELP OF TULSA-PRO SYSTEM
Ultrasound ablation of the prostate, with high-intensity focused ultrasound (HIFU) – is a new and promising tool for the treatment of localized prostate cancers. This method is minimally invasive which makes its use possible where other surgical methods are out of the question.
Profound Medical, a Canadian company, presented an innovative ultrasound ablation system used under MRI guidance for treating prostate cancer, the TULSA-PRO system. They believe this system will completely revolutionize the treatment of prostate cancer.
The procedure is performed under epidural or general anesthesia. MRI guidance is used for more accurate positioning of the transurethral ultrasound applicator containing 10 probes. After the applicator is correctly positioned, the ultrasound probes are selectively turned on. The probes emit energy which is directed at the pathological prostate tissue, heating it up and destroying it. During the procedure, the probe rotates around its own axis making the effect it has on the prostate more uniform.
MRI monitoring allows us to evaluate the procedure’s efficacy.
To avoid undesirable effects on the surrounding tissues, a special endorectal cooling device is inserted into the rectum. Treatment duration depends on the size of the prostate gland, but generally takes around 40-60 minutes.
Clinical trials were held for 12 months in Canada and included 30 patients. Preliminary results on the efficacy of the system were highlighted in the European Urology journal. The following conclusions were made:
- Monitoring during the procedure was accomplished through the use of MRI.
- Precision of ablation was highly accurate, up to 1.3 mm.
- Absence of intraoperative complications (damage to the rectum, fistula formation).
- After 12 months, only 1 patient suffered from 1st degree incontinence.
- Erectile dysfunction was observed in 3 patients (≥2 on the IIEF scale).
- There were no significant changes in the quality of life of the patients.
Currently, the TULSA-PRO system is being used in clinical trials with over 110 patients from 10 medical institutions in Germany, Spain, Netherlands, Canada and the USA, which shows the promising potential and clinical efficacy of the device.