Prof. Nikhil Vasdev
Consultant Urological and Robotic Surgeon, Pinehill Hospital, Hitchin
Mark Rochester
Clinical Director of Urology, Norfolk and Norwich University Hospital
Men are receiving robotically assisted benign prostatic hyperplasia treatment in the UK. The method has been proven to preserve continence and sexual function for patients.
A growing number of men are receiving revolutionary treatment to relieve the debilitating symptoms of enlarged prostates. The procedure utilises robotically assisted surgery and a targeted heat-free waterjet to tackle benign prostatic hyperplasia (BPH), where the prostate gland enlarges and causes difficulty passing urine.
Relieving symptoms caused by benign prostatic hyperplasia
Around 3 million men are affected by BPH, with more than 30,000 a year needing surgery, resulting in a backlog of NHS cases. However, with National Institute for Health and Care Excellence (NICE) recommendation of Aquablation therapy, surgeons are hopeful they can not only cut waiting lists using the technique but also provide better outcomes for patients. It was developed by Procept BioRobotics and available for private and NHS patients.
The procedure takes approximately one hour, has little or no impact on sexual function for men and is normally provided as a day case or one-night stay in the hospital. The treatment, also known as transurethral waterjet ablation, is being made more widely available on the NHS.
Treatment options for benign prostatic hyperplasia
Norfolk and Norwich University Hospital introduced the procedure earlier this year. The hospital’s Clinical Director of Urology, Mr Mark Rochester, says offering a range of treatments remains important as every patient is different in terms of priorities and what they want from the treatments.
One standard treatment for BPH is Trans Urethral Resection of the Prostate (TURP), which is effective in relieving urinary symptoms but can damage parts of the prostate gland essential for sexual function. Other options include a three-hour laser technique known as Holmium Laser Enucleation of Prostate (HoLEP) or using steam or stents to open the prostate to allow passage of urine.
Aquablation therapy surgically removes tissue using a robotically-assisted, heat-free waterjet to resect a channel through the prostate while preserving critical anatomy and sexual function. It’s proving to be a fast and cost-effective option with few side effects.
Rochester says: “After creating the surgical plan, the removal of tissue was robotically executed. It’s efficient use of theatre time, and we’re able to send many patients home the same day.” It can have a positive impact on waiting lists and help reduce NHS backlogs.
With Aquablation therapy, patients notice that
Prof. Nikhil Vasdev
improvement in their waterworks after surgery
is quick, and none have had incontinence,
ejaculatory or erectile complications.
Quicker recovery with fewer side effects
Professor Nikhil Vasdev, Consultant Urological and Robotic Surgeon at Pinehill Hospital in Hitchin, Hertfordshire, has recently started conducting the procedure. He says: “With Aquablation therapy, patients notice that improvement in their waterworks after surgery is quick, and none so far have had incontinence, ejaculatory or erectile complications.
One patient was back at work two weeks after the treatment while another, who had a catheter and could not pass urine, returned to work in four weeks and was catheter-free after 24 hours. “We’re seeing quicker patient recovery compared with traditional treatment, an improvement in outcomes and a reduction in side effects,” adds Professor Vasdev. “That is down to precision of the operation.”
Patients reporting on the outcomes and efficacy
One patient who underwent Aquablation therapy for BPH was retired engineer Surjit Sandhu. He was initially admitted to a hospital in Stevenage where his prostate-specific antigen (PSA) levels were found to be high, and he was placed on intravenous antibiotics before being discharged several days later.
With delays in further investigations, he made an appointment with Professor Vasdev at Pinehill Hospital, where it was confirmed that he had an enlarged prostate. “This was the first time I had medical confirmation that it was BPH and that the growth wasn’t cancerous. This was a huge relief,” says Surjit, 71. After discussing treatment options, the Aquablation therapy procedure was carried out.
“I would recommend this treatment to others who are suffering from an enlarged prostate because the recovery period is less compared to other treatments,” he says. “It’s less invasive and more precise.”
