New surgery solves common men's issue, without affecting sex life

Surgeon Jim Duthie gets guidance from Henry Woo via Skype during a new surgical procedure, the Urolift Photograph by John Borren

Tauranga is the first place in New Zealand to perform innovative surgery to treat the most common male health problem, while still preserving sexual function.

This week, 63-year-old Ōmokoroa man Ed Davies was the first in New Zealand to have groundbreaking prostate surgery known as the Urolift technique.

In a world first, his Tauranga surgeon was mentored during surgery over Skype by the world expert in Urolift surgery.

Tauranga urological surgeon Jim Duthie had not performed the procedure before, so in Grace Hospital theatre was assisted by a laptop, through which Australian surgeon Professor Henry Woo provided guidance from Sydney.

"It was good having a co-pilot," says Duthie, "but even though I have not actually done this before, it's well within my skill set".

Duthie's first Urolift patient, Davies, suffers from an enlarged prostate gland, medically known as Benign Prostatic Hyperplasia (BPH), a condition in which the prostate enlarges as men get older.

Affecting more than one in three New Zealand men over the age of 50, and increasing with age, the condition causes urinary problems which Duthie describes as "typically poor flow, having trouble getting started, having to drop and run, and getting up in the middle of the night".

New prostate surgery being carried out at Grace Hospital. Photograph by John Borren

Woo said the technique was a significant improvement in the treatment of BPH as it was minimally invasive with few side effects.

In a Urolift procedure, implants are inserted to relieve prostate obstruction and open the urethra directly without cutting, heating or removing prostate tissue.

"Previously, patients would require significant medication or general anaesthetic for surgery to remove or laser part of the prostate. These treatments could affect the quality of life, including sexual dysfunction such as erectile problems or inability to ejaculate."

Previous prostate surgery could mean a month off work, but the Urolift had minimal downtime, with no hospital stay and with patients back on their feet within days, said Woo.

Woo first started trialling the procedure in 2005 and received FDA (the US Food and Drug Administration) approval in 2013.

He said more than 70,000 procedures have been done around the world, but until now none had been done in New Zealand, where traditional invasive prostate surgeries are one of the most common types of surgery.

Unlike traditional surgery, Davies' surgery took around 15 minutes, and did not require a hospital stay or catheter.

Duthie said reducing operating time benefited the patient and meant more patients could be treated.

"It means treatment of the enlarged prostate more accessible, safer, quicker and easier for many men. It means they can be free of bothersome symptoms without side effects and minimal downtime."

Currently, the procedure would only be available privately and only through certain insurance companies, but Duthie said that it was a one-off treatment which was actually similar in cost to other treatments, plus with fewer costs incurred from theatre time, overnight stay and related nursing costs.

Davies said he was thrilled to be the first in the country to receive the treatment and was looking forward to being symptom-free, and without having to take medication for the rest of his life. He was not fazed by the fact the guiding surgeon was on Skype.

"I looked him up on YouTube myself... what a way to learn, it is magic."

Benign prostatic hyperplasia (BPH) is a common condition affecting 40 per cent of men aged 50, and increasing with age.

Complications include urinary tract infections and bladder stones, as well as kidney and bladder damage.

The Urolift uses a scope through the urethra to implant medical staples into the prostate which hold swollen tissue out of the way, allowing urine to flow properly and decreasing irritability, frequency and urgency.