New NICE Guidance on Enlarged Prostate

Peter Russell

June 26, 2020

Up to 10,000 men with an enlarged prostate could receive a new treatment to help improve their quality of life and preserve sexual function, new guidance from the National Institute for Health and Care Guidance (NICE) said.

The NHS rationing body said it was recommending Rezum (Boston Scientific), a steam therapy for treating lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH).

The technology uses water vapour to destroy excess prostate tissue with the aim of relieving symptoms.

It said the treatment was an alternative to other current treatments that use heat to destroy excess prostate tissue and which can have considerable side effects.

Benign prostatic hyperplasia affects more than a third of men over the age of 50.

NICE said that cost modelling estimated that Rezum saved money compared with standard treatments such as transurethral resection of the prostate (TURP) and holmium laser enucleation of the prostate (HoLEP) by more than £550 per person over 4 years.

'A Real Difference'

Meindert Boysen, deputy chief executive and director of the Centre for Health Technology Evaluation, said: "This technology could make a real difference to the lives of men up and down the country.

"Our committee has looked at the evidence and believe this quick 20-minute procedure under general or local anaesthetic will relieve the symptoms of an enlarged prostate, something many men suffer in silence with.

"The fact Rezum is unlikely to damage surrounding tissue and nerves means it has a low risk of causing sexual dysfunction."

NICE said that men wishing to access the treatment should speak to their doctor.

Treatment is currently being carried out in 18 NHS centres.

They are:

  • Churchill Hospital, Oxford

  • North Hampshire Hospital, Basingstoke

  • Charing Cross Hospital

  • Clatterbridge Hospital

  • Norfolk and Norwich Hospital

  • East Surrey Hospital

  • Warwick Hospital

  • Wrexham Maelor Hospital

  • Frimley Park Hospital

  • Whiston Hospital

  • St Albans City Hospital

  • Salisbury District Hospital

  • Royal Berkshire Hospital

  • Guys Hospital

  • Royal Hampshire County Hospital, Winchester

  • Bradford Royal Infirmary

  • Queen Margaret Hospital

  • Addenbrooke's Hospital

'Exciting and Innovative'

The vapour is injected for 9 seconds during treatment. The number of times this has to be done in each lobe of the prostate depends on the length of the prostatic urethra. It can be customised to the configuration of the gland. A maximum number of 15 full injections can be done with each delivery device although fewer injections are needed for most treatments. 

Consultant Urological Surgeons Alistair Stewart and Jyoti Basu from Bradford Teaching Hospitals NHS Foundation Trust have received specialist training in delivering the procedure.

Mr Stewart said: "Rezum’ is an exciting new, minimally-invasive treatment option for BPH, which is very common and affects around 50% of men by the age of 60 and up to 90% of men by the age of 85. I’m absolutely thrilled that we have become the first trust in Yorkshire to be able to offer this treatment to our patients. It is going to make a major difference to their quality of life.

"I’m proud to be part of a urology team that is so forward-looking and is well ahead of the game when it comes to technology and breakthroughs in treatments. This latest treatment is another example of the continually improving care we can offer to our patients."
 

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