Histotripsy System Developed to Treat Benign Prostatic Hyperplasia

New technology is providing the surgeon with tools to plan and deliver histotripsy, a non-thermal therapy for the treatment of benign prostate hyperplasia (BPH), a noncancerous enlargement of the prostate. The histotripsy treatment starts with three-dimensional (3D) ultrasound image reconstruction of the prostate. The urologist then generates a 3D outline of the target tissue volume to be treated.

After confirmation of the procedure plan, the urologist precisely navigates the histotripsy treatment through the target volume using joystick controls. The urologist monitors the procedure in real time with ultrasound image guidance throughout the treatment.


Histotripsy employs high intensity acoustic energy to fragment and homogenize cellular tissues through a process known as cavitation. Cavitation appears as a “bubble cloud” on ultrasound imaging and is easily monitored by the surgeon throughout the procedure. Because histotripsy is a mechanical, non-thermal process, the boundary between treated and untreated tissues is very precise. Once treated, tissues change in ultrasound appearance from bright to dark, enabling the surgeon to easily track the treatment as it progresses.

The Vort RX, developed by HistoSonics (Ann Arbor, MI, USA), is an investigational device and is limited by law to investigational use by qualified investigators in the United States and Canada. The company has raised more than USD 14 million in equity financing to support its ultrasound-powered ablation technology, a device the company reported can treat enlarged prostates without the need for surgery.

The device is designed to provide an alternative to pharmaceutical therapy and minimally invasive procedures such as urethra-based ablation, according to HistoSonics spokespersons, and the company believes its technology can enhance patient outcomes and lower healthcare costs.

The company, which spun out of the University of Michigan (Ann Arbor, MI, USA) in 2009, is in the process of undergoing pilot studies for Vortx Rx in the United States and Canada, treating its first US patient in August 2014.

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