NHS approves enlarged prostate steam treatment which could spare millions of men surgery side effects

Blast of boiling water via urethral probe kills cells and relieves pressure without risk of impotence and incontinence

Options for treating serious forms of the condition which affects as many as half of men over 50 were previously limited (Blend/Rex Shutterstock)

The NHS has been given the green light to deploy a new steam treatment for enlarged prostates that could help millions of men avoid the risk of impotence and sexual dysfunction.

On Tuesday the National Institute for Health and Care Excellence (Nice) said there is enough evidence that the procedure, which shrinks the swollen gland, is safe and effective as an alternative to surgery.

Enlarged prostate affects more than two million men, roughly half of men over the age of 50, and serious cases have relied on surgery using a laser or cauterising probe to cut back the gland.

However this brings several risks, including infections, incontinence and impotence, which appear to be a completely avoided in trials of the new treatment, Rezūm, at NHS hospitals.

The procedure inserts a small probe up the urethra and pierces into the prostate at centimetre intervals to deliver 10 second blasts of steam, at 103C, into the tissue.

This causes the cells to break down and be recycled into the body, shrinking the prostate over a period of one to three months.

While it requires local anaesthetic the minimally invasive approach and low risk of side effects mean it can be done in minutes, freeing up precious NHS operating theatre and bed space and potentially saving millions.

Benign prostatic hyperplasia, the medical name for a non-cancerous enlarged prostate, can be extremely disruptive, interrupting work and sleep as the pressure forces men into frequent bathroom visits.

Because the enlarged prostate gland is typically putting pressure on the urethra, urination can be restricted or blocked entirely which can lead to serious kidney infections.

Currently medication is given in the first instance to halt or slow the prostate growth, but by the time it has gotten severe enough to warrant surgery the operation has become more complex and may harm other parts of the tissue.

A surgical procedure can take around 90 minutes and require days of recovery in a bed.

In the UK Rezūm was first performed by Professor Richard Hindley of Hampshire Hospitals NHS Foundation Trust. He and researchers from Imperial College Healthcare NHS Trust in London have together now treated about 150 men.

Professor Hindley has yet to have a patient develop impotence or urinary issues with prostate reduction of around a third being roughly equivalent to surgery. He said: “Rezūm is a very quick procedure and patients can be discharged the same day.

“It is also a non-invasive treatment, meaning there is much less chance of it having side effects, improving quality of life overall.”

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.”