Dr Jonathan Rees
GP, Tyntesfield Medical Group and Chair, Primary Care Urology Society
Minimally-invasive procedures could end the sub-optimal treatment being endured by men with benign prostatic hyperplasia (BPH).
Benign prostatic hyperplasia (BPH) has been described as ‘practically inevitable’ in older men. According to the NHS, 40% of men over 50, and 75% of men in their 70s have urinary symptoms caused by an enlarged prostate, which forces the urine tube to narrow.
There was a time when many men just accepted BPH and its associated symptoms as being part of older age – but not anymore. “In the past, there was a perception that this was an old man’s lot, but people are much more proactive about seeing their doctor,” says Dr Jonathan Rees, a GP with a special interest in urology.
By and large, the first course of treatment for most men is still medication. Alpha blockers, which relax the muscles and make it easier to pass urine, they are effective but are also a lifetime commitment. Surgery is another a proven option for those with more severe symptoms, but with that comes the risk of sexual dysfunction and incontinence.
Minimally-invasive procedures could offer more viable solutions to more men, whereby tiny implants are inserted into the urethra to hold open the obstructed pathway.
“We’re seeing new, minimally-invasive treatments, like this, that are simpler, quicker, cheaper and more tolerable for patients and have a better side-effect profile,” continues Dr Rees. “These could be a consideration for people who might have less severe symptoms, but don’t want to take medication for the next 25 years.”
Better access and results
Alternative treatments could also encourage the estimated 69% of men with BPH who choose not to take medication or undergo traditional surgery, to get the support they need. Dr Rees also believes that the procedures (many of which can be conducted in outpatient, or day case units, under local anaesthetic), could help to improve the quality of life of many patients.
“We realise many men are being sub-optimally controlled on medication but, subjectively, we know they would have better outcomes with minimally-invasive therapy,” he says.
Availability is not consistent
While the new treatments have been approved for use within the NHS, the threshold criteria for referrals differs across the country. This is something that Dr Rees would like to see change.
“What we’re after is a fair and level playing field, so all men get equal access to the therapies,” says Dr Rees. “There is cost, the impact on patients, and there are the side-effects of medication and surgery… We need to look at all these things together.”
With an ageing population, the number of men with BPH is only going to increase and alternative therapies, if universally available, could help ensure these men get the treatment they need.
The UroLift® System treatment is a revolutionary, minimally-invasive approach to treating an enlarged prostate, or BPH, that lifts or holds the enlarged prostate tissue out of the way so it no longer blocks the urethra. There is no cutting, heating or removal of prostate tissue. Clinical data has shown that the UroLift System treatment is safe and effective in relieving lower urinary tract symptoms due to BPH without compromising sexual function1,2,3. The goal of the UroLift System treatment is to relieve symptoms so you can get back to your life and resume your daily activities.
1. Roehrborn, Can J Urol 2015, 3-Year L.I.F.T. Study
2. Roehrborn, Urology Practice 2015, 2-Year L.I.F.T. Study
3. Roehrborn, J Urol 2013, L.I.F.T. Study