Research published by the National Institute for Health Research Health Technology Assessment (NIHR HTA) programme has found that transurethral resection, the most common operation for benign prostatic enlargement (BPE), remains a clinically and cost-effective treatment. BPE commonly causes older men to have difficulty passing urine and may require surgery to alleviate the problem.
Researchers at the University of Aberdeen, led by Professor James N'Dow, examined existing data to determine the risk factors and clinical and cost-effectiveness of less minimally invasive treatments for BPE compared to the current standard of transurethral resection. These included ‘tissue ablative’ treatments such as holmium laser enucleation of prostate (HoLEP); transurethral vaporisation; and ‘minimally invasive’ techniques such as laser coagulation, microwave therapy and transurethral needle ablation. They also looked at the overall long term benefits to patients.
Methods similar to transurethral resection require an anaesthetic, stay in hospital, and can sometimes lead to unwanted side effects such as bleeding. However, some patients do not require general anaesthetic and treatment can be performed within an out patient department using alternative procedures. Newer procedures have been developed but there is uncertainty about their clinical and cost-effectiveness.