TULSA-PRO — India's Only MRI-Guided Prostate Treatment, Available Exclusively at KIMS Secunderabad
TULSA-PRO (Transurethral Ultrasound Ablation) is a prostate cancer and BPH treatment unlike anything else available in India. There is no incision. There is no radiation. There is no general anaesthesia required in most cases. A thin probe is placed through the urethra, guided to the prostate by MRI, and focused ultrasound energy ablates the prostate tissue with millimetre precision under real-time MRI thermometry. The patient goes home the same day or the following morning. And KIMS Secunderabad is the first and only hospital in India to have introduced this technology.
That exclusivity is not a marketing statement it is a clinical fact. As of publication, no other hospital in India offers TULSA-PRO. Men in India who wish to access this treatment have one option: KIMS Secunderabad, 1-8-31/1 Minister Road, Secunderabad, Telangana.
This post explains what TULSA-PRO is, how it works, what the clinical outcomes are, who it is appropriate for, and how it compares to the other prostate treatments available at KIMS — TURP, HoLEP, and radiation so that every man reading this can make an informed decision about whether TULSA-PRO is the right option for him.
What is TULSA-PRO — the technology explained
TULSA stands for Transurethral Ultrasound Ablation the delivery mechanism is a thin probe passed through the urethra into the prostate. Within this probe, rotating ultrasound transducers generate focused ultrasound energy that is directed through the urethral wall into the surrounding prostate tissue. As the transducers rotate, they ablate a precise arc of prostate tissue at a controlled depth, controlled temperature, and controlled extent all guided in real-time by MRI.
The MRI guidance is what makes TULSA-PRO fundamentally different from all other prostate treatments. During the procedure, the patient lies inside an MRI scanner. Real-time MRI thermometry a specialised MRI sequence that maps tissue temperature with millimetre spatial resolution displays the heat distribution within the prostate as it is being treated. The treating physician can see exactly where the ablation zone is extending, how close it is to the urethral lining (which must be cooled to protect continence), and when the target temperature has been reached in each treatment zone. Structures outside the target, the urethra, the rectal wall, the neurovascular bundles controlling erection are continuously monitored and protected.
The result: a prostate treatment that achieves precise, controlled ablation of the target tissue prostate cancer focus, BPH adenoma, or both while actively protecting the structures that determine quality of life. The precision of MRI-guided thermometry is what makes TULSA-PRO's quality-of-life outcomes particularly ejaculation preservation significantly better than surgery or radiation.
KIMS Secunderabad is India's first and only TULSA-PRO centre. No other hospital in India offers this treatment. Patients from across India, Hyderabad, Mumbai, Bengaluru, Chennai, Delhi, and beyond travel to KIMS Secunderabad for TULSA-PRO. If you are researching TULSA-PRO in India, KIMS Secunderabad is your only option within the country.
What TULSA-PRO treats — prostate cancer and BPH
Prostate cancer — focal or whole-gland ablation
TULSA-PRO is used for localised prostate cancer — cancer confined to the prostate gland, typically in men with low to intermediate-risk disease who wish to avoid surgery and radiation. Two treatment approaches are used:
Focal ablation: When cancer is localised to one side or a specific area, TULSA-PRO ablates only the cancer-bearing region. This approach maximises functional preservation, keeping neurovascular bundles undisturbed and preserving ejaculatory function in most men.
Whole-gland ablation: When cancer is multifocal, the entire prostate is treated. The urethral cooling system built into the TULSA probe protects the urethral sphincter, maintaining urinary continence even during whole-gland treatment.
BPH — treatment for enlarged prostate symptoms
TULSA-PRO is also an effective alternative to HoLEP, TURP, or medication for men with Benign Prostatic Hyperplasia (BPH) who want symptom relief without surgery.
The obstructing adenoma is ablated through the TULSA probe, effectively opening the urinary channel. For men currently on long-term BPH medication who desire a definitive treatment without committing to a surgical procedure, TULSA-PRO offers an attractive middle path with excellent preservation of ejaculatory function.
Clinical outcomes — what the TACT trial showed
The TACT (TULSA-PRO Ablation Clinical Trial) was the pivotal international multicentre trial that established TULSA-PRO's clinical evidence base and led to FDA approval in the United States. The trial enrolled 115 men with localised prostate cancer across 13 sites. Key outcomes at 1 year:
95% Median PSA Reduction
PSA dropped from a median baseline of 6.3 ng/ml to 0.31 ng/ml at 12 months. This magnitude is comparable to surgery and significantly better than radiation.
93% Continence Preservation
93% of men were pad-free at 1 year, reflecting the effectiveness of the urethral cooling mechanism in protecting the sphincter during treatment.
75% Erectile Function Recovery
Significantly better than published rates after radical prostatectomy (40–60%) and comparable to radiation for sexually active participants.
Ejaculation Preservation
Substantially better than surgery or radiation. Most men retain antegrade ejaculation, which is disrupted in 75% of men after TURP/HoLEP.
Effective Cancer Ablation
The majority of evaluable patients showed no viable cancer cells in the treated zone on follow-up biopsy at the 1-year mark.
A Transparent Note on Data: The TACT trial results represent early-phase outcomes. TULSA-PRO does not yet have the 10 to 20 year follow-up data that radical prostatectomy and radiation have accumulated over decades. This is a transparent limitation that the KIMS team discusses at every TULSA-PRO consultation. For men who prioritise quality of life and accept close surveillance follow-up, the trade-off of excellent early outcomes against limited long-term data is a reasonable clinical decision.
Who is a candidate for TULSA-PRO?
Patient selection for TULSA-PRO requires careful assessment by the KIMS urology and uro-oncology team. The following criteria guide candidate selection:
For Prostate Cancer
• Risk Level: PSA below 20 ng/ml, Gleason Grade Group 1 to 3 (Gleason 6 to 4+3=7). Selected high-risk patients may be considered after multidisciplinary discussion.
• Prostate Volume: prostate anatomy assessed on MRI for suitability. Very large prostates (above 80cc in some systems) or prostates with significant calcification that would scatter ultrasound require specific assessment.
• MRI Compatibility: metallic implants incompatible with MRI, severe claustrophobia, or inability to lie still for the procedure duration (approximately 2 to 3 hours in the MRI scanner).
• No Prior Treatment: men who have had prior TURP, radiation, or focal ablation may have anatomical changes that affect TULSA-PRO candidacy.
For BPH
• Anatomy: no calcification pattern that would interfere with ultrasound delivery.
• Preference: particularly relevant for men who prioritise ejaculation preservation and same-day discharge.
Important Note: Not every prostate is suitable for TULSA-PRO. Candidacy requires MRI assessment of size, calcification, and tumour location. The KIMS team provides an honest assessment; some men may be better served by HoLEP, TURP, or RARP.
The TULSA-PRO procedure — what happens on the day
TULSA-PRO at KIMS is performed in the specialized MRI suite. The procedure takes approximately 2 to 3 hours from start to finish, of which the active treatment time is typically 45 to 90 minutes:
Preparation
The patient is given spinal anaesthesia (or conscious sedation in some cases) to ensure they remain still in the MRI scanner throughout. A urethral catheter is placed for the procedure.
Probe Placement
The TULSA probe is inserted through the urethra and positioned at the level of the prostate. The urethral cooling system within the probe circulates cooled saline to protect the urethral lining during treatment. A rectal cooling device is also placed to protect the rectal wall.
MRI Planning
The treating physician uses the real-time MRI images to map the prostate and define the treatment zone, marking which areas to ablate and which structures to protect.
Active Treatment
The rotating ultrasound transducers deliver energy in a controlled arc while the MRI thermometry displays temperature maps in real-time. The physician monitors and adjusts the treatment continuously based on the temperature feedback.
Post-Treatment
The probe is removed. Post-procedure MRI confirms the ablation zone. The patient is transferred to the ward for observation.
Discharge
most patients are discharged the same day or the following morning. A urethral catheter is typically worn for 5 to 7 days after the procedure, then removed in the outpatient clinic.
TULSA-PRO vs other prostate treatments — how KIMS makes the recommendation
| Factor | TULSA-PRO | HoLEP (100W at KIMS) | TURP (Bipolar at KIMS) |
|---|---|---|---|
| Incision | None — entirely through urethra. | None — endoscopic. | None — endoscopic. |
| Anaesthesia | Spinal or sedation — no general anaesthesia in most cases. | Spinal or general. | Spinal or general. |
| Hospital stay | Same day or next morning. | 1–2 nights. | 2–3 nights. |
| Catheter duration | 5–7 days. | Typically 24 hours. | 48–72 hours. |
| Ejaculation preservation | Best of the three — most men retain antegrade ejaculation. | ~25% retained — retrograde ejaculation in ~75%. | ~25% retained — retrograde ejaculation in ~75%. |
| Urinary continence | 93% pad-free at 1 year (TACT trial). | Excellent — comparable to TURP. | Excellent. |
| 5-year retreatment rate | ~10–15% (emerging data). | <2% — lowest of all BPH procedures. | ~15% — residual tissue continues to grow. |
| Prostate cancer treatment | Yes — for localised prostate cancer. | No — BPH only. | No — BPH only. |
| Evidence base | 5+ years — FDA approved. Limited long-term data vs surgery. | 25+ years — well-established. | 40+ years — the most studied BPH procedure. |
| Available in India | KIMS Secunderabad — only centre in India. | Multiple centres. | Multiple centres. |
Frequently Asked Questions — TULSA-PRO
Yes — at KIMS Secunderabad. KIMS Hospitals, 1-8-31/1 Minister Road, Secunderabad, Telangana 500003, is India's first and only TULSA-PRO centre. No other hospital in India offers this treatment as of the date of this publication. Patients from across India travel to KIMS Secunderabad for TULSA-PRO. To book a TULSA-PRO candidacy assessment, call 040 - 44885000 or email assistance@kimshospitals.com.
Yes — TULSA-PRO received FDA clearance in the United States in 2019 based on the TACT (TULSA-PRO Ablation Clinical Trial) data. It is also CE marked in Europe. These regulatory approvals confirm that TULSA-PRO has met the safety and efficacy standards required for clinical use. At KIMS, TULSA-PRO is offered for both prostate cancer (localised, low to intermediate-risk) and BPH the two indications for which the pivotal clinical data were collected.
TULSA-PRO achieves effective ablation of the targeted prostate tissue confirmed by PSA reduction (median 95% at 1 year in the TACT trial) and negative biopsy at the treated zone in follow-up. Whether this constitutes 'cure' in the long-term sense depends on the completeness of ablation, the cancer grade, and the follow-up duration. TULSA-PRO does not yet have the 10 to 20 year oncological follow-up data that radical prostatectomy and radiation have accumulated. This is the honest limitation: excellent early outcomes from a relatively new technology, without the long-term durability data of established treatments. Men with localised low to intermediate-risk prostate cancer who choose TULSA-PRO commit to close follow-up PSA every 3 to 6 months, and repeat MRI and biopsy at defined intervals with the option to proceed to radical treatment if cancer recurs or progresses.
Most TULSA-PRO procedures are performed under spinal anaesthesia the patient is awake but completely numb from the waist down or under conscious sedation. General anaesthesia (being fully asleep) is not routinely required. The requirement to remain still inside the MRI scanner for 2 to 3 hours is the main challenge spinal anaesthesia or sedation ensures the patient is comfortable and immobile. Men with specific medical reasons for avoiding spinal anaesthesia are assessed individually for the most appropriate anaesthetic approach.
Both TULSA-PRO and radiation therapy (external beam radiotherapy or brachytherapy) treat prostate cancer without surgery. Key differences: TULSA-PRO takes a single session of 2 to 3 hours; external beam radiation requires 20 to 39 treatment sessions over 4 to 8 weeks. TULSA-PRO achieves a more rapid and dramatic PSA reduction (median 95% at 1 year) than radiation, which lowers PSA more gradually over 18 to 24 months. TULSA-PRO's ejaculation preservation is significantly better than brachytherapy (which has high rates of retrograde ejaculation from prostate oedema) and broadly comparable to IMRT/IGRT. TULSA-PRO avoids the risk of radiation to adjacent structures (rectum, bladder) that causes the late gastrointestinal and urological toxicities associated with prostate radiation in a minority of patients. Radiation has 20+ years of follow-up data; TULSA-PRO has 5 to 7 years. Both are reasonable options for localised prostate cancer the choice depends on the patient's priorities and tumour characteristics.
Recovery after TULSA-PRO is faster than after prostate surgery. The catheter is worn for 5 to 7 days after the procedure and removed at the outpatient clinic. In the first 2 to 4 weeks, patients may experience temporary urinary frequency, urgency, and mild dysuria as the treated prostate tissue swells, then gradually softens and resolves. Return to desk work is typically within 3 to 5 days of catheter removal. Strenuous exercise is avoided for 2 to 4 weeks. There is no wound to heal and no significant pain from the procedure itself. PSA is monitored at 3 months and 12 months as the primary indicator of treatment response.
Call 040 - 44885000 or email assistance@kimshospitals.com and request a TULSA-PRO candidacy consultation. Bring your most recent PSA result, prostate MRI report, and biopsy report (if you have had a biopsy). The KIMS urology team led by Dr. Neil Narendra Trivedi and Dr. Y. M. Prashanth will assess your candidacy based on your prostate anatomy, cancer stage and grade, and treatment priorities. If TULSA-PRO is not the most appropriate option for your specific situation, the team will recommend the most suitable alternative HoLEP, TURP, RARP, or radiation with the same objectivity that makes KIMS the only centre in India where all these options are available alongside TULSA-PRO.
KIMS Secunderabad — the only hospital in India to offer TULSA-PRO. Address: KIMS Institute of Renal Sciences & Advanced Urology, 1-8-31/1 Minister Road, Secunderabad, Telangana 500003. Phone: 040 - 44885000. Email: assistance@kimshospitals.com. India's first TULSA-PRO centre, introduced in 2023. NABH and NABL accredited.