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Heartbeat: Urology demonstrate recovery of surgical services

August 1, 2021

Urologists at City Hospital have shown that the introduction of an innovative treatment for men with enlarged prostates, combined with new efficient ways of working, can not only benefit patients but can also help with the post-COVID-19 recovery of surgical services. Patients with benign urological conditions, such as benign prostatic hyperplasia (BPH), who require surgery to treat their symptoms have been particularly hard hit by the impact of the pandemic.

Consultant Urologist, Ananda Dhanasekaran joined the urology team at City Hospital in 2015, bringing with him the aim of introducing novel, NICErecommended treatments to patients with benign urological conditions. Supported by the urology team and the surgical directorate, in 2018, he started offering patients with symptoms of BPH a totally new approach to their condition – UroLift (a prostatic urethral lift). UroLift had been recommended by NICE and, at the time, was one of the innovations supported by NHS England as part of its innovation and technology programme.

This novel treatment is designed to relieve symptoms, is very quick and requires minimal time in hospital. This contrasts with traditional surgical treatments for BPH, such as TURP which involves a general anaesthetic, a longer procedure time, an inpatient stay of 1-3 days and a lengthy recovery.

The urology team have also developed ways to make the treatment pathway more efficient and easier for the patient. They were the first in the country to carry out the UroLift procedure under a complete local anaesthetic with no sedation or anaesthesia. A one-stop assessment clinic for patients with symptoms of BPH also means that the number of times a patient needs to visit the hospital is minimised.

Ananda said: “Introducing innovative treatments like UroLift offers benefits including improved patient experience and quality of care. Compared with traditional surgical approaches, the new treatment is associated with improvement in quality of life, preservation of sexual function and quick recovery time. We have also found that a simplified pathway, involving fewer preoperative investigations, did not compromise outcomes and was associated with shorter waiting times for treatment.”

There are also important benefits for the Trust by being able to streamline the patient pathway and a reduced requirement for theatre time and inpatient beds. These benefits have been brought sharply into focus this past year due to the COVID-19 pandemic, where patients with benign urological conditions have been most affected by the impact of the pandemic on elective non-cancer surgical services. Three or four UroLift procedures can be completed in the time it takes to perform a single TURP. With the current backlog of patients with benign urological conditions awaiting surgery, offering UroLift instead of TURP where appropriate, means it will be possible to treat these patients and relieve their symptoms quicker. Also, by using UroLift which does not require an overnight stay, inpatient bed capacity is also freed up for patients who require it.

Ananda said: “Our Trust now offers UroLift to a wider range of patients with more complex prostate anatomies and we are glad to see now our SWBH trust is a recognised UroLift training centre.”

By offering minimally invasive treatments like UroLift to patients who need surgery for BPH, Ananda and the team have shown how adopting innovation can be part of the solution to post-COVID-19 recovery of surgical services.