25 Nov A pioneering procedure at #Colchester General Hospital could be opened up for all
A Langham grandfather is calling for a pioneering procedure at Colchester General Hospital to be made available throughout the NHS.
Mike Mays is one of just 14 patients who have undergone the non-surgical procedure there in order to reduce the size of his prostate.
Known as prostatic artery embolisation (PAE), the technique is currently available in just 16 UK hospitals to treat benign prostatic hyperplasia (BPH) with Colchester being the only one in the NHS eastern region.
Performed under a local anaesthetic, PAE involves using a tiny plastic catheter inserted through the groin to place grain-sized particles into the arteries to reduce the blood supply and shrink the gland.
Mr Mays, 72, had the procedure earlier this year at Colchester General Hospital after initially going to his GP at Ardleigh Surgery because he was getting up four or five times in the night to go to the toilet
“Although I was awake during the procedure, in many ways I didn’t feel a thing apart from an odd sensation in my midriff which was far from unpleasant,” he said.
“It was a bit tedious lying there for two hours on my back but from time to time I was able to look at a screen to see what was going on.
“Now, I get up at most twice a night to go to the toilet and from my own experience I would like this procedure to become widely available throughout the Health Service.”
Mr Mays, who lives with his wife Sylvia in Wick Road, Langham, spent one night in Colchester General Hospital after the operation. The couple have two children and four grandchildren.
BPH forces the gland to compress the urethra – the tube between the bladder and the penis – and delays the start of urination, increases the need to urinate and prevents patients’ emptying the bladder.
There are other causes of urinary obstruction so every patient’s symptoms are initially assessed by a consultant urologist. If the patient would benefit from PAE, the urologist then liaises with an interventional radiologist.
PAE is carried out by interventional radiologists, who are specially trained doctors with expertise in using X-ray equipment, interpreting the images produced and inserting needles and fine catheters into blood vessels through the skin.
The two interventional radiologists in Colchester who have been performing the procedure are Dr Arun Sebastian and Dr Nagendra Thayur.
Dr Sebastian, who carried out Mr Mays’ procedure, said: “Enlarged prostate affects about three out of five men over 60 and is usually treated with medication and lifestyle changes.
“If these are unsuccessful, invasive surgery has traditionally been the next option but the potential side effects of this include incontinence and impotence which are not associated with embolisation.
“However, the new technique is not suitable for all men with an enlarged prostate, such as those men whose arteries are already starting to become blocked, and patients need to be assessed by a urologist first.”
Dr Sebastian underwent PAE training in Lisbon and Dr Thayur in Southampton, where the procedure was carried out for the first time in the UK in April 2012.
Dr Sebastian said the outcome of the PAE procedures in Colchester had been positive. For example, a consultant urological surgeon colleague had written to him to say that one patient who had a PAE could now go through the night needing to go to the toilet just once compared to 7-8 times previously.
Because Colchester is the only hospital in the East of England to provide PAE, patients have come from as far as Norwich and Cambridge to have the procedure. Patients are able to return home on the same day as their PAE but if they come from outside of north east Essex or live on their own, they are usually able to stay in hospital overnight.
Dr Sebastian used to chair a committee of the British Society of Interventional Radiology which, with the British Association of Urological Surgeons and the National Institute for Health and Care Execellence (NICE), set up a national study into the effectiveness of the procedure.
NICE has funded Cedar, an NHS academic evaluation centre, to compare results of PAE with conventional surgery via a registry of prostate embolisation, known as UK-ROPE. NICE will then recommend if PAE should become more widely available in the NHS.
PAEs in Colchester have been funded by the Postgraduate Medical Centre Charitable Trust Fund (£25,000) at Colchester General Hospital and the hospital’s Radiology Research Fund (£20,000).
PAE was first performed in 2009, and since then more than 900 men have had the procedure, predominantly in Portugal, Brazil and the USA.
It usually takes between one and two hours to complete with little or no recovery period required, compared to a 2-3 day hospital stay and a month-long recovery and rest period following surgery.