Published: 25 August 2020
New NIHR-funded research reveals that two procedures to treat men with an enlarged prostate gland are both effective.
The prostate gland sits at the exit of the bladder like a collar and as men get older it is common for it to get bigger. When it enlarges it can be difficult, or even impossible, for men to pass urine or can cause other bothersome urinary symptoms. 25,000 men each year have an operation to relieve this problem by reducing the size of the prostate, making it one of the most common operations performed in the NHS.
Now results of a study led by the Bristol Urological Institute, at North Bristol NHS Trust are published in The Lancet.
The trial compared the current ‘gold’ standard treatment of TURP (Transurethral Resection of the Prostate) to a laser technique called ThuVARP (Thulium Laser Transurethral Vaporesection of the Prostate). TURP is generally a very successful surgical procedure that involves cutting away a section of the prostate, although it does have some complications.The trial was carried out as there was a suggestion that the laser procedure may result in a shorter stay in hospital following the operation, and reduced complications such as bleeding than the TURP.
Between July 2014 and December 2016, 410 men wishing to reduce lower urinary tract symptoms were randomly assigned to receive either a ThuVARP or TURP procedure.
Twelve months post-surgery there were similar improvements in patient-reported urinary symptoms for both procedures. Urinary flow also improved successfully although slightly more after the TURP than the laser procedure. Men reported similar quality of life and sexual symptoms after both procedures and high satisfaction with surgery. There was no difference between the two procedures in hospital stay or complications, including bleeding. TURP was slightly more cost effective and took less time than the laser procedure.
Lead author, Professor Hashim Hashim, Consultant Urological Surgeon & Honorary Professor of Urology at Bristol Urological Institute, said: “Overall, this trial has shown that both procedures are effective for treating men with lower tract symptoms. The results will inform national guidance and ensure that men are receiving the best available treatment”.
The study was funded by NIHR’s Health Technology Assessment (HTA) Programme
More information about the study is available on the NIHR’s Funding & Awards website.