Frimley Health tackles prostate surgery waiting lists with new NHS record

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Surgeons at Frimley Health NHS Foundation Trust have treated a record number of men with enlarged prostates in a single day using a pioneering robotically-assisted heat-free waterjet technique. 

The NICE-approved procedure, called Aquablation therapy, was performed on 12 patients in one day, a record for an NHS hospital in England. Eleven out of the 12 patients were carried out as day cases which allows the patients to recover in the comfort of their own home and helps to free-up valuable bed spaces in the hospital. 

Neil Barber, Consultant Urological Surgeon and clinical lead for Urology, Frimley Health NHS Foundation Trust:  “We usually perform a maximum of three Aquablation  procedures in one half day operating list per week. However, growing demand from both local patients and those referred from further afield is increasing the waiting list. We wanted to utilise this technology to see what we could achieve to help patients waiting for treatment and demonstrate that the efficiency of treatment of Aquablation can really impact the waiting list.” 

Aquablation therapy is used to treat men with BPH (benign prostatic hyperplasia), a non-cancerous condition which leads to an enlarged prostate and causes significant lower urinary tract symptoms. The system uses a heat-free high-pressure waterjet and real-time advanced imaging to remove the excess tissue and relieve symptoms, with greater preservation of erectile and ejaculatory preservation and faster recovery times than traditional techniques.

Over one million men in the UK are on BPH medication, with an estimated 50% between the ages of 50 and 60, and up to 90% of men over 80.  BPH can make men feel they need to urinate more often, but they find it difficult to empty their bladder completely. The condition causes problems passing urine, including the need to urinate frequently and/or urgently, leading to sleep disruption, incontinence and infections. Leaving BPH untreated can lead to urinary retention (complete inability to pass urine) and long-term damage to the kidneys and bladder. 

Neil Barber continued: “The biggest benefits of Aquablation therapy are its efficiency and predictability, which means we can treat a greater volume and achieve better outcomes. Thanks to the incredible hard work of our surgical team, the day was a huge success. We were able to perform a record number of procedures with more than 90% as day cases and shows what we could achieve for our patients in the future, with the right support in place.” 

Frimley Health was the first NHS trust in England to introduce the robotic Aquablation therapy procedure and led the initial global trials to help develop and evolve the technique. Since its introduction, the trust has carried out the highest number of NHS Aquablation therapy procedures in the country - with more than 500 patients being treated in the last five years.  Following the success of the ‘record-breaking’ day, more will be held in the future, and there are aspirations to introduce a second Aquablation therapy system to help a greater number of patients across the trust.    

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One patient treated on Frimley Health’s record-breaking day was Nigel Howlett, 68, from Farnham in Surrey. He had been suffering from symptoms associated with BPH and was on the waiting list for treatment for 18 months. 

Mr Howlett said: “I’ve lived with this for a long time, including a significant lack of sleep and then not drinking enough liquids to try and prevent the need to urinate. It might not be one of the most crucial procedures for the NHS but it has greatly affected my quality of life. This day is a very good idea to help patients like me who have waited too long. I feel fine after the procedure, I’m going home this afternoon and I’m hoping it will make quite a big difference to my symptoms in the future.” 

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Harry Matadeen, 74, from Farnborough said: “I’m just about to go into theatre for my operation. The sleep disturbance has been the biggest issue for me – I can be up eight times in the night so I’m constantly tired. This is a great way to treat more patients, and holding it on a Saturday is actually more convenient for me.” 

The most recognised surgical treatment for treating benign, enlarged prostates, TURP (transurethral resection of the prostate) is not routinely provided as a day case,  can cause physical strain to the surgeon to achieve a higher number of patients in one day, carries a burden of risks to sexual dysfunction and perhaps equally importantly lacks predictability in surgical time – larger prostates taking longer, so leading to difficulty in scheduling efficient use of operating theatre time.  

Unlike more conventional treatments, Aquablation therapy is clinically proven for the preservation of sexual function and urinary continence. The system used at Frimley Health is the PROCEPT BioRobotics AQUABEAM®, which provides a minimally invasive treatment option.