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Steam treatment for enlarged prostate approved for use on NHS

Transurethral water vapour ablation may cause less sexual dysfunction than current surgical options as it is less invasive

Ingrid Torjesen

Wednesday, 22 August 2018

A new steam treatment called transurethral water vapour ablation has been approved for the treatment of lower urinary tract symptoms caused by benign prostatic hyperplasia by the National Institute for Health and Care Excellence (NICE).

Transurethral water vapour ablation involves a retractable needle being inserted into the prostate and steam (at a temperature of about 103 degrees centigrade) is delivered for eight to 10 seconds. The heat disrupts cell membranes in the prostate, leading to rapid cell death. The needle is retracted and repositioned several times so the procedure can be repeated in different areas of the gland.

The aim of the treatment is to reduce the size of the prostate, leading to improvement in lower urinary tract symptoms one to three months after treatment, without impairing sexual function.

Patients may have to take antibiotics and have a urinary catheter for some days after the procedure, and some activities, including sexual intercourse, should be avoided for up to one month.

The steam treatment is less invasive than surgery, which means patients could be seen as day cases and may experience fewer side-effects, such as impotence and incontinence.

Professor Kevin Harris, programme director and clinical advisor for the Interventional Procedures Programme at NICE, said: “This treatment is one of a number of options that are effective and safe for benign prostatic hyperplasia.

“Approving this procedure gives men the chance to talk to their clinician about which is right for them.”

Patients with benign prostatic hyperplasia are currently usually treated with drugs such as alpha blockers and 5-alpha-reductase inhibitors, and if these fail there are a range of surgical options that can be offered, including transurethral resection of the prostate. However, the potential complications of these procedures, include bleeding, infection, urethral strictures, incontinence and sexual dysfunction.

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