For some men, the prospect of retirement brings the happy expectation of long days spent out on the golf course. However, what if a common medical condition was to put paid to such long walks around an 18-hole course?
This particular medical problem is experienced by men only as it affects the prostate organ. Happily, it can be treated and one of the ways to do this is by using an innovative new vapour treatment called Rezum.
An enlarged prostate is a common problem experienced by men over 50. The condition affects almost 1:3 men in their 50s, and symptoms can include urinary problems, sleepless nights and decreased quality of life.
The condition can cause those affected to urinate much more frequently and it is this aspect of the condition that can have negative effect on lifestyle. Other symptoms are; problems with initiating urination (hesitancy), interruption of the urine flow (intermittency) and difficulty in emptying the
bladder, which in turn, can increase the risk of urinary tract infections. Traditional treatment for this condition routinely involves medication, however pills are not always effective and, in some cases, can result in side-effects. Another option would be to look at surgical procedures such as Green Light laser surgery or Holmium enucleation procedure which removes part of the prostate to improve urine flow out of the bladder.
The drawbacks with traditional surgery however, are that these interventions are invasive, may require a stay in hospital and can affect sexual function.
So how good would be to be in a position to offer a treatment to men that would not involve medication or even an overnight stay in hospital?
This was exactly the thoughts of Mr Feras al Jaafari, Consultant Urological Surgeon when, together with his team, he introduced a pioneering new treatment known as Rezum to the Urology surgery department earlier this year.
Rezum was approved last year by the National Institute for Health and Care Excellence (NICE). The procedure involves small jets of steam injected into the prostate to destroy excess tissue which then causes the prostate to shrink over a period of weeks. This new procedure is significantly less invasive than traditional surgical interventions for the condition, meaning that patients can receive the treatment and return home the same day. As the procedure does require a general anaesthetic it is a real benefit that it only takes 10 minutes to perform the surgery as it is ultimately far
safer for patients to spend less time under anaesthetic conditions. Recovery is also quicker than with the alternative surgical interventions with patients up and able to go home just hours after the procedure. Mr Al Jaafari points out that only Rezum can currently offer such truly minimally invasive surgery for benign prostate issues. He also explains that this procedure only requires a gentle anaesthetic and therefore carries the least possible side effects for the patient.
Mr Feras Al Jafaari performs Rezum therapy with theatre team at Queen Margaret Hospital, Fife
N.B. Video content features a surgical procedure which may not be suitable for some viewers
One of the first patients to benefit from this new procedure was Jack Ker. Now retired and a keen golfer himself, it was around 6 years ago that Jack first started to suffer in the form of having to get up during the night to urinate – sometimes as many as 3-4 times.
On seeing a doctor, it was discovered that he had a urine infection and was treated for this using medication in the form of pills. At this time however, it was discovered that he had a high PSA. PSA stands for prostate specific antigen, a protein made only by the prostate gland. Since anything over 5 is concerning, John was invited for further tests and it was at this point that thankfully, prostate cancer was ruled out, but a benign enlargement of his prostate was diagnosed.
At the time, various treatment options were offered to Jack, but the side effects of these were off putting. The doctor also explained that the alternative Urolift surgery was not possible due to the size of the enlarged organ. So Jack was delighted, when late last year, he got a call from the hospital inviting him to discuss having treatment via a new procedure called Rezum. With very few side effects, and the possibility of being seen as a day surgery patient, Jack decided that this was the treatment route he wanted to go down.
Jack has now had the treatment which took place in December 2020. He’s also now had his 3 month review appointment which confirmed a significant improvement of his symptoms but also a further drop of his PSA to a reassuring value, suggesting a degree of prostate shrinkage. Speaking about the procedure, which is performed under anaesthetic, Jack had absolutely no complaints. Whilst he did admit to some pre surgery nerves, post operation he felt great and slept extremely well.
Importantly, the procedure enables patients to recover more quickly than alternative surgical interventions, and because the treatment takes only 20 minutes, patients are required to spend much less time under general anaesthetic, which is ultimately safer.
Jack was back on the golf course less than two weeks after surgery once his catheter was removed. He did admit to being a little apprehensive when going back to hospital to have the catheter taken out but later admitted that he needn’t have worried as the removal was as quick as it was painless. When we asked about other side effects, he did mention that it took a while for his urine flow to get back to normal, but again, this is a perfectly normal outcome of the treatment and resolves itself over a short number of weeks.
All in all, Jack said that he couldn’t be happier with the Rezum treatment and added that he’d be recommending the procedure to all his fellow golfers once back on the green.
Another fantastic benefit for patients and the NHS is that the speed of this procedure will allow surgeons to treat more patients, thus reducing the overall time men have to wait for treatment.
In addition to the numerous benefits this treatment can offer to patients, the nature of the procedure means that it can be performed in a fraction of the time it takes to perform conventional surgery for
benign enlarged prostate, meaning that NHS Fife will likely be able to treat more patients and reduce time people have to wait for treatment which ultimately benefits everyone.