Breakthrough treatment cures prostate condition without surgery

A radical new steam treatment could offer hope to millions of middle-aged men who suffer from an enlarged prostate.

The five-minute procedure to shrink the gland cuts the need for surgery and comes with minimal side effects.

Health watchdogs are expected to give it the green light for routine NHS use tomorrow.

Two million men in Britain have been diagnosed with an enlarged prostate – but it is thought to affect as many as half of all men over the age of 50, and 60 per cent of those over 60.

The problem commonly causes repetitive night-time visits to the bathroom, but many men find that having rushed out of bed, they cannot urinate after all.

The new treatment – which involves injecting an enlarged prostate with jets of steam – avoids the severe impacts of invasive operations that can often spell an early end to a man’s sex life.

An enlarged prostate is not linked to cancer and does not increase the risk of getting prostate cancer – yet the symptoms can be similar, so most men with the problem are tested to make sure their prostate is not cancerous.

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It is caused by benign prostatic hyperplasia, in which an overgrown prostate presses into the bladder and blocks the urethra, the vessel through which it empties.

In extreme cases, men find they cannot urinate, leading to a dangerous build-up of toxins that can cause severe kidney problems. Every year more than 18,000 men undergo a painful operation to relieve the problem, which involves removing part of the prostate. However, the vast majority with the condition avoid surgery because of fears over side effects.

While the operation – called transurethral resection of the prostate (TURP) – is effective, it can lead to loss of sexual function, bleeding and incontinence.

The steam treatment, called Rezum, simply shrinks the prostate with few side effects. The procedure, performed under local anaesthetic and sedation, involves injecting nine-second bursts of steam into the prostate, via a thin tube inserted into the urethra.

The steam is injected at 1cm intervals, killing enough prostate tissue to shrink the enlarged gland.

Surgeons at Imperial College Healthcare NHS Trust in London and Hampshire Hospitals NHS Foundation Trust have trialled the procedure on 150 men, with remarkable results.

Professor Hashim Ahmed, a consultant urological surgeon at Imperial, said other hospitals are poised to roll out the treatment as soon as they get the okay from health watchdog NICE.

“A huge group of men could benefit from this treatment,” he said. Experts believe it will in time completely replace TURP. But they also think many more men who until now have been reluctant to undergo an operation will take up the steam option. Professor Ahmed said: “There is a large group of men who are so worried about the side effects of an operation that they are suffering without treatment, or relying on drugs and their side effects.”

He said the Rezum treatment – which is made by US firm NxThera – could save the NHS money.

“It frees up huge NHS resources because you need much less theatre time,” he said.

“You are also opening up tens of thousands of days of bed occupation around the country.”

Conventional TURP operations take 90 minutes in surgery and an average of three days of recovery time in an NHS bed. The Rezum treatment, in comparison, takes just five minutes.

Professor Ahmed said: “From arriving in theatre to leaving again is taking no more than 15 minutes. And it is a day case – there is no need to take an NHS bed.” The Rezum procedure costs the NHS about £2,000 – roughly the same as TURP – but taking into account theatre time and no need for a bed it could save the health service millions. Privately it costs about £5,000, compared to £6,000 for TURP.

Professor Ahmed and Professor Richard Hindley of Hampshire Hospitals, who performed the first Rezum procedure in Basingstoke last year, have compiled the results of their first 80 patients to receive the treatment.

On average their patients’ prostates shrunk by 36 per cent – a comparable result to TURP. But remarkably, the side effects have been minimal.

Professor Ahmed said: “We have seen zero incontinence and virtually zero impotence. And you get a quicker recovery, meaning you can get back to work and get on with your life.”

For patients who receive TURP, in comparison, roughly 10 per cent are left with erectile problems and two per cent have permanent urinary incontinence.

Roughly 65 per cent are also left with ejaculation problems – for Rezum it is about five per cent.

Professor Ahmed stressed there are some disadvantages of the steam treatment. He said: “It is not instant – it might take three to eight weeks to see the benefit, it is a slow burn.”

The technology may also be unsuitable for men with the largest prostates – who would be better off having a high-tech laser surgery treatment.

Rezum is the latest in a series of non-surgical options for enlarged prostates to emerge in the last year.

Another treatment involves blocking the blood supply to the prostate by injecting tiny plastic beads into an artery.

Professor Hindley, who does his academic work at the University of Winchester, added: “This could be a game-changer for the NHS. You can do five or six cases in half a day.”