NNUH Urology team offers new robotic procedure for men with enlarged prostates

The Norfolk and Norwich University Hospitals Urology team are the first in the East of England and only the fourth NHS hospital nationwide to offer a new less invasive robotic treatment to men with enlarged prostates.

NNUH urologists joined their counterparts at Guy’s and St Thomas’, the Royal Berkshire and Basingstoke and North Hampshire NHS Trusts in providing Aquablation to men with enlarged prostates who meet the criteria.

Aquablation is a robotic procedure that uses a high-pressure saline solution to remove tissue from an enlarged prostate. It has shown in multiple trials to have fewer side effects including preserving sexual function, than the more common TURP (Transurethral Resection of the Prostate) procedure that involves cutting away the section of the prostate using heat. It has shown to reduce operating time and bed stay time. It can be up to 45% faster to provide the procedure (30-40 minutes compared with 70-80 minutes) with some patients going home the same day or staying just one night. Most men will have the catheter removed the next day, improving patient experience and also helping improve bed capacity.

The urology team led by Mark Rochester, Consultant Surgeon and Service Director for Urology, and his colleague NNUH Urology Consultant Surgeon, Utsav Reddy, have been instrumental in bringing the service to the hospital. They have been operating on patients using this technology since April 2023.

Utsav said: “We are using ultra-sound guided robotic technology to remove the unwanted tissue. It is using robotic technology to do something we have been doing manually for years. So far around 20,000 of these robotic procedures have been carried out worldwide. Because it is heat-free there is no burning of tissue and the technology it’s incredibly accurate, removing only the tissue that needs to be removed.

“It is early days. Patients are telling us they are pleased with the outcomes, and we are gathering data on this.”

He added: “Because the procedure is faster, we can also carry out more operations in a day. There is a bit more setting up time needed, but overall, we can see more men in a day, possibly six or seven instead of four or five.”

Mark added: “We see a large number of patients ranging from 50-95 years of age and they all have different priorities. For some it might be to be free of the catheter they have to have, for some it might be preserving sexual function. By being able to offer this treatment along with other similar treatments means we have greater patient choice. And, by seeing more patients per day, waiting times are reduced which is hugely impactful for someone who has been waiting with a catheter.”

Builder Martin Hayes, from Long Stratton, was one of the first patients to have the Aquablation procedure and at 55 he is the youngest to have this procedure at the N&N.

He had a narrowing of the urethra which caused repeated infections. An MRI showed he had a prostate three times its original size.

After spending months self-catheterising and enduring the infections, he was told he was eligible for the procedure.

“It was marvellous. Brilliant. The best thing I have ever done.

“Mr Reddy was just brilliant. He put me at my ease told me what to expect and he has given me life back.

“You don’t realise but this creeps up on you and then it’s just how you have to live your life. I was getting up five or six times in the night. Now it is only a couple of times. I was having broken sleep; I had no energy and now I have noticed a real difference – the whole family has.

“When we were going out the first question was always where’s the loo. We went to Thursford last year to the show and I just didn’t enjoy it. I just accepted that this was my life.”

Martin added: “At first, they thought it couldn’t be my prostate because at 55 I was too young. It just goes to show you have to get checked out. There is nothing to be embarrassed about. See your doctor and get it sorted out.”

Alan Reeve, 77, of Reepham, was also one of the first patients to receive this procedure after spending 14 months on a catheter which limited his normally active lifestyle.

He said: “I went in to have the procedure and was home within 48 hours. In about a week I was, what I would consider pretty much back to normal.”

I know people with an enlarged prostate who have had hot wire treatment and laser treatment and they had said how horrendous that was.

“I didn’t have any pain. Only the first 12 hours or so was rough when they took the catheter away and I experienced a level of incontinence and diarrhoea. I also had some heavy bleeding to begin with, but the doctors were not concerned about this, and I was allowed home.”

“I have been improving ever since and I am booked in with Mr Reddy’s clinic in September.”

Mr Reeve added: “Having a catheter is not a pleasant experience. With the catheter I would get an infection and that was not pleasant either. Now I can do what I want when I want and go wherever I want.”

“I’m a 77-year-old man, who keeps himself relatively fit. I have an active lifestyle. I own a very small amount of shares in horses and like to see them race at Newmarket. I like to meet up with friends and I like to take the coach down to London to see a West End show.

“My lifestyle is not limited at all now.”

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