The disclosure describes a hand-held device that utilizes a mechanical lever system to operate the device with a single hand. The mechanical lever system is coupled to a sliding element within the housing of the hand-held device that slides linearly. The sliding element may be attached to another element that is extended, retracted, or rotated in or out of the device. For example, the hand-held device may be used for prostate ablation therapy. The hand-held device may include an ablation needle electrode that is extended out of a catheter and into a tissue of a patient by depressing an extension lever of the mechanical lever system to deliver ablation therapy. Depressing a retraction lever of the mechanical lever system may retract the needle electrode back into the catheter of the hand-held device. Other variations of the mechanical system and applications of the hand-held device are also described.