TULSA-PRO · Prostate treatment evidence
The TULSA procedure (TULSA-PRO): how it works, recovery and results
TULSA-PRO uses ultrasound to heat and destroy chosen prostate tissue. The heat comes from a device placed in the urethra, the tube that carries urine out of the body. MRI guides the treatment. Most men who have the whole prostate treated need a catheter for about two weeks. Results differ for new cancer, an enlarged prostate and cancer that returns after radiation, so start with the guide that fits you.
Medically reviewed by Michael O. Koch, MD · September 23, 2026 · Updated September 30, 2026
Four things to know first
- Plan for a catheter. Serious problems are uncommon. But Dr. Koch notes that most men need a urinary catheter for about two weeks after whole-gland treatment. Trouble passing urine can last longer. In the CAPTAIN trial, the typical (median) catheter time was 13 days after TULSA and 8 days after robotic surgery. CAPTAIN early results.
- Infection is a real risk. Dr. Koch points to two causes: bacteria that can live in the bladder, and prostate tissue that dies after the heat. Ask how your team checks for infection and what to do if you get a fever.
- A lower PSA is not proof that all cancer is gone. In the TACT study, 25 of 115 men (22%) had more cancer treatment within five years. More men, 39 of 111 (35%), had some cancer on a biopsy one year after TULSA. Dr. Koch says the gap is mostly small Gleason 6 cancers that doctors are watching. One-year biopsy. Five-year report.
- Quick recovery is not the same as cancer control. CAPTAIN compares TULSA with surgery. Its first report found less pain and a faster return to normal activity after TULSA. It has not yet reported whether TULSA controls cancer as well.
Pick the guide that matches your question
There are six guides. One covers the procedure. Three cover different medical situations. One covers treating only part of the prostate. One explains the research. Each guide lists its evidence, its limits and questions to ask.
How the TULSA procedure works: planning, treatment day and recovery
What happens before, during and after treatment, including the catheter, infection risk and follow-up tests.
Read the guide →TULSA-PRO for localized prostate cancer: what the results show
Who TULSA may suit, what the TACT numbers mean, and the comparison with surgery that is still unfinished.
Read the guide →Focal therapy and TULSA-PRO: understanding the treatment area
Focal therapy is a plan, TULSA is a device. Ask what is known inside and outside the area to be treated.
Read the guide →TULSA-PRO for BPH: early results for blocked urine flow
Two small studies, what they measured, and why symptom relief is not the same as cancer treatment.
Read the guide →TULSA after radiation: checking the cancer and the urinary risks
Two small studies of TULSA after radiation, including serious complications. Results from untreated men do not apply.
Read the guide →TULSA-PRO clinical studies: how to compare the evidence
Check who was treated, how much of the prostate, what was measured and for how long before you compare percentages.
Read the guide →Which question are you asking?
| Your question | Start here | Keep in mind |
|---|---|---|
| What happens during treatment? | The procedure and recovery | How the device works is a separate question from whether it is right for your diagnosis. |
| I have new cancer that has not spread. | Localized prostate cancer | Your risk group matters. A lower PSA and a clear biopsy are different results. |
| Can only part of the prostate be treated? | Focal (partial) treatment | TULSA is a device. “Focal” is a plan to treat only part of the gland. |
| I want treatment for blocked urine flow. | BPH and urine flow | Small studies of urinary symptoms do not show cancer results. They do not prove TULSA beats other BPH treatments. |
| Cancer may be back after radiation. | Treatment after radiation | Past radiation changes the risks. Published results include serious urinary side effects. |
| How strong is the research? | The clinical studies | Check who was treated, what was measured, how many were counted and for how long before you compare percentages. |
What FDA clearance means, and what it does not
The FDA cleared the device to destroy (ablate) prostate tissue. That is not a promise that it cures cancer. It is also not proof that TULSA is better than surgery, radiation or other treatments. You still need the studies for your diagnosis and a doctor who knows your case. FDA clearance. FDA guidance on disease claims.
Why each situation gets its own page
The studies of new cancer, enlarged prostate and cancer after radiation treated different men. They also measured different results. For example, the phase II study of treatment after radiation found severe urinary side effects in 28% of men. A general line about “low risk” cannot cover that. The guides keep these groups apart.
CAPTAIN is the trial to watch for a direct comparison with prostate removal (prostatectomy). Men in it are randomly assigned to TULSA or robotic surgery. A 2026 conference abstract found that TULSA had less blood loss, less pain, no overnight hospital stay and a faster return to normal activity. The catheter stayed in longer after TULSA. The study has not yet answered the long-term cancer-control question. Read the early CAPTAIN abstract. View the trial record.
Use the questions in each guide to get ready for a talk with your care team. These pages explain the evidence and what is still unknown. They do not choose a treatment or decide who qualifies.
Take these questions to your care team
Modern Prostate Institute does not offer patient intake or TULSA provider matching. Talk with your own doctor or a hospital urology service about your records and options. Do not send medical records through a public contact form.
Read our care-navigation guidance →
Medically reviewed by
Michael O. Koch, MD
John P. Donohue Professor of Urology at Indiana University School of Medicine. He chaired the university’s urology department from 1998 to 2024. Dr. Koch reviewed these TULSA pages on September 23, 2026 and sent the corrections included here. He is an author of the TACT five-year and CAPTAIN reports cited on these pages.
About Dr. Koch and his review →