Transurethral Ultrasound Ablation (TULSA-PRO) for BPH

Broader than Focal, Less than Total

A transurethral ultrasound ablation procedure (TULSA-PRO) can more easily cover a wider area than laser focal therapy (LFT) / focal laser ablation (FLA).  For patients who have a relatively larger prostate, TULSA-PRO can cover a larger area while having the control of real time thermal feedback.  

This is a minimally invasive procedure performed at the Prostate Laser Center (a HALO Diagnostics Company) that combines real-time 3T MRI with robotically-driven directional thermal ultrasound energy to perform subtotal or targeted prostate gland ablation. There are no incisions or radiation.

TULSA-PRO is a customizable, predictable, and incision-free procedure that allows the doctor to tailor the ablation to each patient. Once the boundary lines and volume-to-be-ablated are mapped, the ablation process is computer controlled with real time temperature feedback. The procedure is performed with high-intensity directional ultrasound to ablate tissue in a controlled manner.


BPH is not prostate cancer, but minimally invasive treatments for prostate cancer LFT and TULSA-PRO have proven to successfully treat BPH with no incisions, radiation, and with a lower risk of side effects.

TULSA-PRO is an effective option for men with BPH as it destroys enlarged prostate tissue while avoiding damaging vital structures. Because TULSA-PRO is an inside-out procedure, and the distance from the urethra is shorter, more energy can be focused on the enlarged tissue surrounding the urethra.

TULSA-PRO, like LFT / FLA, is a minimally invasive treatment. The procedure is completed in one treatment session and performed under general anesthesia.

Benign Prostatic Hyperplasia

Individualized Elements

After the placement of the device and initial MRI scanning, the physician enters a treatment plan. The TULSA-PRO system then individually controls ten separate elements, allowing for broad tissue destruction while fine tuning each treatment area. This is all performed under the watchful eye of the physician who can make adjustments as appropriate. 

An endorectal cooling system protects the rectum. (The patient is asleep before that goes in.)

Tulsa Prostate Diagram

Advantages of Treating BPH with TULSA-PRO

Icon Decreased Side Effects Blue

Minimally Invasive

Icon Outpatient Procedure Blue

Same-Day Outpatient Procedure

Icon No Anesthesia Blue

No Incisions

Icon Improved Accuracy Blue

Icon Personalized Treatment Plan
Personalized Treatment Plans

Icon Improved Accuracy Blue

Advanced Image Guidance

TULSA-PRO used to treat BPH is similar to treating prostate cancer. Learn more about TULSA-PRO for prostate cancer.

How Dr. Karamanian Performs the TULSA Procedure

The TULSA procedure (TULSA-PRO) ablates prostate tissue from the inside out. A device enters the urethra which delivers thermal ultrasound energy outwards from the urethra to the prostate while under real-time MRI guidance.

This approach avoids the need for surgical incisions to reach the prostate. A cooling mechanism helps protect the urethra from the ultrasound energy. The thermal ultrasound energy is delivered in a sweeping motion (visualize a clock hand sweeping), which enables the physician to ablate a wider area.

Tulsa Pro Procedure Video
Play Video about Tulsa Pro Procedure Video
Tulsa Pro Imaging

TULSA-PRO produces real-time temperature maps, enabling the physician to see the increasing temperature of the prostate tissue and surrounding structures every 5-7 seconds during treatment. This visibility allows the physician to actively monitor tissue heating.

Frequently Asked Questions

Generally, yes.  The physician can customize the procedure to ablate specific areas of the prostate based on the patient’s needs.

Patients interested in the TULSA procedure must be screened by an MRI professional (technologist or radiologist) before entering the MRI suite. Whether a patient qualifies for the TULSA procedure will be determined by a physician.

What to Expect

Transurethral Ultrasound Ablation for BPH

Wondering what to expect before, during, and after TULSA-PRO? Take a look here.

Dr Ara Karamanian

Interested in our treatment options?

Request a Consultation