The Bristol Urological Institute, a world renowned centre for urological research and urodynamics, at North Bristol NHS Trust is leading the major three year national multi-centre trial. It’s being managed by the Bristol Randomised Trials Collaboration at the University of Bristol.
As men get older it’s common for their prostate gland to get bigger. The prostate gland sits at the exit of the bladder like a collar so when it enlarges it can be difficult, or even impossible, for men to pass urine or can cause other bothersome urinary symptoms.
Around 25,000 men each year have an operation to relieve this problem by reducing the size of the prostate, making it one of the most common operations performed in the NHS.
The trial looks at a new type of laser called Thulium, which cuts and vaporises the prostate and has shown promising results. This is an easier technique for surgeons to do than previous lasers, and there is some evidence to indicate that patients may benefit from reduced blood loss and a faster return home after their operation.
At present the ‘gold’ standard operation for bladder obstruction due to benign prostatic enlargement is called Transurethral Resection of the Prostate (TURP), which has a long history in the NHS and is generally very successful, although it can have some complications.
Various laser procedures have been tried but have not become widely used, either because they have been difficult to do, or because the results were not as successful as TURP for relieving symptoms.
This three year trial will compare TURP with the laser operation to find out which gives the better results, to establish which is safer and better value for patients and the NHS.
The trial has now started recruiting patients, and 410 patients will be randomly allocated to either the laser procedure or standard TURP operation across six centres.
The research team were awarded funding for the trial by a Health Technology Assessment Surgery Themed Call by the National Institute for Health Research.
Mr Hashim Hashim, Consultant Urological Surgeon and Director of the Urodynamics Unit at the Bristol Urological Institute, is leading the trial. He said: “This important trial will allow us to provide national recommendations on the surgical treatment of benign prostatic enlargement, ensuring that we are giving men the best available treatment.”
Dr Athene Lane, Co-Director of the Bristol Randomised Trials Collaboration, said: “Patient recruitment is now underway for this exciting trial being led from Bristol, with centres across the UK. The new laser technology will be comprehensively compared to the current standard operation for this common condition, allowing us to determine which operation is most beneficial for patients and the NHS.”
About the NIHR
The NIHR is funded by the Department of Health to improve the health and wealth of the nation through research. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government’s strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence, and systems represent the most integrated health research system in the world. For further information, visit the NIHR website.
The National Institute for Health Research Health Technology Assessment (NIHR HTA) Programme funds research about the effectiveness, costs, and broader impact of health technologies for those who use, manage and provide care in the NHS. It is the largest NIHR programme and publishes the results of its research in the Health Technology Assessment journal, with over 600 issues published to date. The journal’s 2011 Impact Factor (4.255) ranked it in the top 10% of medical and health-related journals. All issues are available for download, free of charge, from the website. The HTA Programme is funded by the NIHR, with contributions from the CSO in Scotland, NISCHR in Wales, and the HSC R&D Division, Public Health Agency in Northern Ireland.
This article presents independent research funded by the National Institute for Health Research (NIHR). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.