Why Anglia Prostate?
For each individual man with urinary problems there is often a range of medications and different surgical procedures that may be suitable. They vary in terms of length of procedure and hospital stay, risk of side effects and effectiveness in improving symptoms.
Mr Yardy is an established respected urologist (Consultant since 2012, performing Urolift since 2016, Rezum since 2019 and Aquablation since 2024). As we are able to offer the full range of treatments explained in this website, we can assess you thoroughly then explain the pros and cons specifically as they apply to you, considering your urinary symptoms, size of prostate, other medical conditions, lifestyle factors and views on risks and recovery times.
Urinary retention is the inability to pass urine at all. It requires insertion of a catheter, often as an emergency, to relieve blockage caused by the prostate. In most men with persistent urinary retention, prostate surgery offers the best chance of getting rid of the catheter.
Already on a waiting list?
If you are already on a waiting list for a prostate operation then it is likely that you will have been given an idea of the waiting time. It is usually possible for us to schedule surgery within one month.
Mr Yardy works with all the major health insurers. We can provide a “package price” for prostate procedures for self pay patients including all hospital fees and follow-up. Please contact us and we can let you know the options in more detail. Our fees usually compare favourably with other private services in East Anglia. Chrysalis Finance is available to spread the cost of treatment over 6 to 36 months.
The team includes specialist anaesthetists, theatre, recovery and ward staff and physiotherapists who are very experienced in looking after men with prostate problems before, during and after prostate surgery
About the surgeon
George Yardy FRCS graduated from St George’s Hospital Medical School, London, in 1997. He undertook research into genetics of prostate cancer at the Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Oxford, for which he was awarded the degree of Doctor of Medicine (MD). His urological training was in the East of England, including two years each at Addenbrooke’s Hospital and Norfolk and Norwich Hospital. He was appointed as a Consultant Urological Surgeon in 2012.
He enjoys teaching and is a Senior Lecturer at the University of East Anglia.
He has particular interest and expertise in the management of BPH and was one of the first surgeons to offer Urolift in East Anglia (in 2016), Rezum (in 2019) and Aquablation (in 2024).
He is on the clinical panel of the “Prostate Matters” information resource: prostatematters.co.uk/prostate-cancer/molecular-tests-for-prostate-cancer/
Causes of urinary problems in men
The urinary symptoms that can trouble men typically consist of one or several of:
- Difficulty starting a stream of urine
- Poor urinary stream
- Dribbling or leakage
- Going too often overnight or during the daytime
- Sudden urge to pass urine
- Urinary retention – inability to pass urine at all,requiring insertion of a catheter
There can be multiple factors contributing to these symptoms, such as neurological conditions, diabetes, infection, stones or anatomical differences that people were born with but the principal cause is usually blockage of bladder emptying due to an enlarged prostate (BOO – bladder outlet obstruction).
Benign Prostatic Hyperplasia
Benign Prostatic Hyperplasia (or BPH) is non-cancerous enlargement of the prostate and is the usual cause of BOO. The cause of BPH is not fully understood but it is controlled by the male hormone testosterone and continues to develop progressively with age. Some men with significantly enlarged prostates have minor symptoms, but others with only slightly enlarged prostates can have marked difficulties passing urine.
There is quite a wide range of treatments available for BOO due to BPH. They are not all suitable for everyone. To be honest, they are all a compromise, with various benefits and drawbacks to consider. At Anglia Prostate, as we are able to offer the full range of treatments, our advice and recommendations are less biased than those of a urologist with more limited experience and repertoire.
Factors to be considered:
Nature and severity of symptoms, Size of prostate, Other medical conditions, Balancing personal views on side effects, speed of recovery. Whether to have a procedure so a man can stop taking prostate medication, recover quickly and return to normal activities, accepting that further treatment may be required later; or consider a procedure with a slightly longer hospital stay and recovery but more marked and long-lasting improvement in symptoms
Non-invasive treatments
This includes lifestyle changes (varying fluid intake at different times of day), specialist physiotherapy (including bladder training and pelvic floor muscle exercises) and drug treatment (medications are available to relax or shrink the prostate and moderate bladder overactivity).
Aquablation Therapy
A robotic device precisely administers a water jet within the prostate. This is undertaken under anaesthetic with continuous monitoring using an ultrasound scan. Patients usually go home from hospital the same day or after one night. Side effects are minimised as heat and electrical current are not used to remove prostate tissue. The rate of incontinence and problems with erections and ejaculation are very low.
BPH Treatment with Lasting Relief – Aquablation® UK
Minimally invasive surgical treatments (MIST)
These include Rezum, Prostate Artery Embolisation (PAE) and Urolift. They are generally characterised by short hospital stay, quick recovery, lower sexual side effects (especially changes in ejaculation) but less improvement in symptoms and shorter duration of effect.
Rezum - prostate steam treatment / water vapour therapy
This is a similar procedure in that it is usually performed under a short anaesthetic and patients go home the same day. A device is inserted down the end of the penis, then a probe extends into several areas within the lobes of the prostate to deliver applications of steam. The treated prostate swells up, then gradually shrinks away over some weeks. A catheter is inserted afterwards and removed around a week later. It also treats moderately enlarged prostates, with quick recovery and minimal effect on sexual function.
More information about Rezum treatment can be found here:
www.rezum.com/what-is-rezum.html
iTind
The iTind treatment (Temporary Implanted Nitinol Device) requires a short procedure to insert a device into the prostate. Men go home the same day and the device gradually expands over a week to change the shape of the water pipe as it runs through the prostate. The device is then removed under local anaesthetic. Urinary symptoms improve quickly, recovery time is short and sexual function is preserved. The size and shape of your prostate also determine whether you are suitable for this procedure.
Prostate Artery Embolisation (PAE)
Tiny beads are placed into blood vessels feeding the prostate under X-ray guidance by a radiologist under sedation. It takes longer than the other MIST procedures but patients still go home the same day. Sexual dysfunction is rare and larger prostates can be treated. It is less effective at improving symptoms but may be particularly suitable for men with other medical problems that would make a full anaesthetic risky.
Urolift (prostatic urethral lift)
This procedure involves precise placement of tiny “clips” within the prostate to lift the obstructing prostatic lobes aside. Although no tissue is actually removed, the shape of the prostate, especially the part of the urethra (water pipe) that runs through it, is remodelled and blockage is relieved. It is suitable for moderately enlarged prostates, men leave hospital the same day without a catheter and recover quickly. Sexual side-effects are rare.
Cavitating procedures
These include transurethral resection of the prostate (TURP) and laser surgery (including holmium laser enucleation of the prostate – HOLEP). They require a longer time in the operating theatre, longer hospital stay and recovery period but result in a greater improvement in symptoms and lower chance of needing further surgery.
Transurethral resection of the prostate (TURP)
This is the established prostate operation. It has been performed and refined over decades. An instrument on the end of a telescope is passed down the water pipe and “bores out” the prostate to remove up to half of the prostate from the inside. All the tissue that is causing blockage is trimmed away then flushed out to send to the laboratory for examination under a microscope. This takes around an hour in the operating theatre. A catheter is inserted into the bladder at the end of the operation and removed before the patient goes home two days later. Recovery is longer – although it is important to be “up and about”, mobile and active soon afterwards, men need to take things easy and avoid straining for four weeks following the procedure. There is a 10% risk of problems with erections, for many men ejaculation is different and there is also a tiny risk of urinary leakage, but it improves symptoms significantly, helps men with particularly severe symptoms and also medium to large prostates, and lasts for a long time so most men never require any further prostate surgery.
Holmium laser enucleation of the prostate (HoLEP)
This is a particularly good operation for men with very large prostates. Tissue is cut away from the inside of the prostate in a similar way to TURP and it is safe to continue the operation for several hours. Similarly, a catheter inserted at the end of the operation is removed before discharge from hospital a couple of days later. There are higher rates of incontinence, especially early incontinence (within the first few months after the operation) but reoperation rates are very low.
Bipolar TURP
Mr Yardy now performs bipolar TURP (including the Olympus Plasma system and Storz bipolar resection). This is the latest generation of TURP with lower bleeding rates, shorter operating time and hospital stay, quicker recovery and fewer side effects. As it combines advantages of conventional TURP and laser surgery, larger prostates which would previously only be suitable for Holep can now be successfully treated.
Other treatments on the horizon
Stents
Stents are tubes made of artificial material which are inserted into various parts of the body to relieve blockages – such as bowel obstruction or narrowing in arteries of the heart. In urology, stents are effective in relieving blockages in the ureter (tube from kidney to bladder) due to stones. Metallic stents have been used in the prostate but there were problems due to stone formation on them, and migration of stents into the bladder, from where they were difficult to retrieve. There is a new generation of stents in development which are using modern materials to overcome these problems.
Drug-eluting devices
Just as there are stents available which slowly release drugs into blood vessels in the heart and elsewhere to slowly prevent scarring and further narrowing, devices are starting to be used to deliver drugs directly into the prostate to gradually control cell growth to relieve blockage caused by BPH.
Book your consultation
Appointments are available at Nuffield Health Ipswich Hospital
To book a consultation please contact us either by phone or email and we will get back to you as soon as possible.
07379 499788 info@angliaprostate.co.uk
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