Article révisé par les pairs
Résumé : Transurethral needle ablation is a new method of treating benign prostatic hyperplasia. Needles on a urethral catheter deliver low-level radiofrequency power directly to a localized area of the prostate. Extensive coagulative necrosis is produced by central lesion temperatures above 100°C. The needles have adjustable shields to protect the urethra if necessary. The instrument is positioned by direct vision using fibre optics. Clinical and pathological studies of transurethral needle ablation have shown the following: (1) that it is feasible and safe; (2) that it can create localized controlled necrotic lesions, as demonstrated by histopathological studies of operative specimen and magnetic resonance imaging; (3) an excellent tolerance of the procedure as an anaesthesia-free outpatient treatment; and (4) an excellent improvement in objective and subjective parameters, such as peak flow rate and International Prostate Symptom Score, after 6 months. Transurethral needle ablation is a promising, anaesthesia-free, alternative treatment for men with symptomatic benign prostatic hyperplasia, but long-term outcome will require further evaluation over several years.