Transurethral Ultrasound Ablation

Image of doctor with patient

Mount Sinai offers a comprehensive, team approach to prostate care. Our radiologists and urologists use the latest technologies. This includes prostate imaging and robotic and image-guided treatment. Transurethral ultrasound ablation (TULSA) integrates state-of-the-art magnetic resonance imaging (MRI) technology with real-time thermal ablation. This allows us to precisely target and destroy cancerous or enlarged prostate tissue. And it protects the surrounding structures. TULSA minimizes side effects and promotes faster recovery. This minimally invasive technique is highly effective for both benign prostatic hyperplasia (BPH), a condition also known as an enlarged prostate, and prostate cancer. Mount Sinai offers New York City’s first MRI-guided TULSA program.

How It Works

For your comfort, we perform TULSA under general anesthesia. For both BPH and prostate cancer, you begin by lying on a treatment table inside an MRI machine. Then we insert a tiny tube (called a catheter) through the urethra. This device delivers heat to the diseased prostate tissue. The catheter also has a cooling mechanism that protects your healthy tissue from the heat. Because we use real-time MRI, we can assess exactly how the treatment is going and can adjust as needed. This way, we destroy only the diseased tissue, keeping healthy tissue intact. TULSA minimizes side effects and promotes faster recovery.

BPH: The procedure typically lasts one to two hours.

Prostate cancer: The procedure usually takes one to three hours, depending on the prostate size and treatment area.

In both cases, you should be able to go home the same day. You will have a temporary Foley catheter for a week or two after the procedure; this is a small tube that gently goes into the bladder and drains urine into a bag. You may experience mild discomfort, a little blood in the urine, and a sudden urge to urinate.

Benefits of TULSA

TULSA offers a variety of benefits. These include:

  • Incision-free alternative to surgery or radiation
  • Real-time MRI and robotic control for tailored treatment
  • Reduced side-effect risk, including incontinence and erectile dysfunction
  • Same-day treatment
  • Medicare-covered at approved centers
  • Collaborative care, working closely with your urologist and radiologist

Most patients maintain their sexual and urinary function after the procedure.

You may be a candidate for TULSA if you:

  • Wish to avoid more invasive surgical procedures
  • Have low- to intermediate-risk prostate cancer that is
    organ-confined—found only in the prostate
  • Find that oral medication does not adequately manage your lower urinary tract BPH symptoms

A Mount Sinai TULSA consultation will help determine whether this procedure is right for you. Please call to make an appointment.

Meet Our Team

Our team is highly trained and skilled. Our interventional radiologists work closely with our urologists to provide personalized, compassionate care.

  • Christine Chen, MD
    TULSA Lead
    Associate Professor, Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai
  • Aaron M. Fischman, MD, FSIR, FCIRSE, FSVM
    TULSA Co-Lead
    Professor, Diagnostic, Molecular, and Interventional Radiology, Urology, and Surgery, Icahn School of Medicine at Mount Sinai
    Program Director, Interventional Radiology Residency, Mount Sinai Health System
  • Michael A. Palese, MD
    Surgeon
    Chair, Department of Urology, Mount Sinai Downtown-Union Square
    Professor, Department of Urology, Icahn School of Medicine at Mount Sinai
    Director, Minimally Invasive Surgery, Mount Sinai Health System
  • Kyrollis Attalla, MD
    Urologic Oncologist
    Assistant Professor, Department of Urology, Icahn School of Medicine at Mount Sinai
  • Jessica Duggan, FNP-BC
    Nurse Practitioner