TULSA-PRO® Prostate Cancer & BPH Treatment

What is TULSA-PRO?

‘TULSA’ stands for Transurethral Ultrasound Ablation. It is a minimally invasive procedure performed by Dr. Ara Karamanian that combines real-time 3T MRI with robotically driven directional thermal ultrasound energy to perform whole or partial prostate gland tissue ablation.

Real-time MR Imaging

Directional Thermal Ultrasound

Closed-loop Temperature Feedback

The TULSA system works by delivering ultrasound heat energy from a device inside the urethra to the prostate to ablate diseased tissue.

There are no surgical incisions or radiation required. The procedure is performed in a state-of-the-art 3T MRI suite allowing Dr. Karamanian to monitor the prostate in real time. 

MRI thermometry provides real-time feedback on the temperature of prostate tissue throughout the procedure. The endorectal cooling system protects the rectum. 

Treatment That Works From the Inside Out

Advantages of TULSA-PRO

Decreased Risk of Side Effects

Real time MRI imaging guidance and the TULSA cooling system enable Dr. Karamanian to safely ablate cancerous tissue.

Same Day Outpatient Procedure

TULSA is performed with the patient under general anesthesia in a single session that takes just a few hours. Patients may return to their hotel room afterward. 

Keep Your Options Open

In the event of recurrence or need for other future prostate care, the TULSA procedure can be repeated. TULSA also doesn’t rule out the ability to have a different procedure down the road.  

Precision Focused

The TULSA system automatically adjusts ultrasound energy output to precisely ablate the treatment area while prioritizing safety and efficacy outcomes.

Personalized Treatment Plans

Every procedure is customized based on each patient’s unique anatomy and disease. TULSA also automatically adjusts to treat variations in tissue properties and blood flow.

Shared Decision Making

With TULSA, you are a part of the treatment planning process. Dr. Karamanian talks you through every step of the process to ensure that you understand your procedure. 

How Dr. Karamanian Performs the TULSA Procedure

The TULSA Procedure 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. It avoids direct thermal contact with the neurovascular bundles surrounding the prostate and with the rectum, which reduces the risk of side effects like erectile dysfunction and incontinence. A cooling mechanism protects the urethra from the ultrasound energy. The thermal ultrasound energy is delivered in a sweeping directional motion, which enables Dr. Karamanian to reach more prostate tissue and ablate more efficiently. 


The TULSA procedure produces realtime temperature maps, enabling Dr. Karamanian to see the temperature of the prostate tissue and surrounding structures every 5-7 seconds during treatment.


This visibility allows Dr. Karamanian to actively monitor tissue heating and make changes to the treatment delivery if necessary, making the TULSA procedure controlled and predictable.

HALO Diagnostics and the Prostate Laser Center have treated men from throughout North America and all around the world