How it Works
The TULSA-PRO Procedure
The TULSA PRO or Transurethral Ultrasound Ablation Procedure is a minimally invasive procedure that uses directional ultrasound to produce very high temperatures to ablate (destroy) targeted prostate tissue. The TULSA PRO system ablates prostate tissue from the “inside-out” meaning that it avoids direct contact with the neurovascular bundles (NVBs) surrounding the prostate. Traditional methods of treating prostate cancer can lead to damage of these NVBs which has been known to result in erectile dysfunction or incontinence. By using the TULSA PRO’s “inside-out” method, Dr. Hong avoids direct contact with the NVBs, helping to preserve his patient’s functional abilities.
The TULSA-PRO Procedure
1. Device Insertion
A device called the ultrasound applicator (UA) is inserted into the urethra, which delivers the ultrasound energy toward the prostate using 10 individually controlled transducer elements.
The UA has a cooling mechanism that protects the urethra from ultrasound energy. An endorectal cooling device (ECD) is also inserted into the rectum protecting rectal tissue and helping to preserve the patient’s natural functions.
The UA has a cooling mechanism that protects the urethra from ultrasound energy. An endorectal cooling device (ECD) is also inserted into the rectum protecting rectal tissue and helping to preserve the patient’s natural functions.
2. Clear MRI Views
Using high-precision MRI imaging, Dr. Hong can clearly see the prostate in the coronal, sagittal, and axial views.
3. Boundary Lines
With these images, Dr. Hong draws the boundary lines around the prostate section corresponding to each transducer element. For example, to the left, a specific boundary line is drawn for transducer element 4.
4. Prostate Ablation
Dr. Hong draws separate boundary lines for the rest of the transducer elements until the entire targeted prostate tissue region is selected and ready for ablation. The example below shows a whole-gland ablation.
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Focal Outcomes
0
%
of men reported preservation of erectile function at 1 to 2 years1
0
%
of men reported preservation of continence and were pad-free at 1 to 2 years1
Whole-Gland Outcomes
0
%
of men reported maintenance or recovery of erectile function at 3 years2
0
%
of men reported continence and no men were incontinent at 3 years2
1. Lumiani, et al. “Single center retrospective analysis of fifty-two prostate cancer patients with customized MR-guided transurethral ultrasound ablation (TULSA)” Urologic Oncology (2021)
2. Klotz, et al. “MP46-03-Pivotal trial of MRI-guided transurethral ultrasound ablation in men with localized prostate cancer: Three-year follow-up”. The Journal of Urology Suppl (2021)
2. Klotz, et al. “MP46-03-Pivotal trial of MRI-guided transurethral ultrasound ablation in men with localized prostate cancer: Three-year follow-up”. The Journal of Urology Suppl (2021)
