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Residents’ Podcast: NICE Guidance – GreenLight XPS for treating benign prostatic hyperplasia

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Veeru Kasivisvanathan

SpR in Urology & NIHR Doctoral Fellow, University College London & University College Hospital London.

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This National Institute for Health and Care Excellence (NICE) guidance is the current, unaltered NICE guidance at time of publication. BJUI publishes selected NICE guidance relevant to urologists to extend their distribution and promote best practice.

 Recommendations

  • 1.1
    The case for adopting GreenLight XPS for treating benign prostatic hyperplasia is supported in non-high-risk patients. GreenLight XPS is at least as effective in these patients as transurethral resection of the prostate (TURP), but can more often be done as a day-case procedure, following appropriate service redesign.
  • 1.2

    There is currently insufficient high-quality, comparative evidence to support the routine adoption of GreenLight XPS in high-risk patients, that is those who:

    • have an increased risk of bleeding or
    • have prostates larger than 100 ml or
    • have urinary retention.

    NICE recommends that specialists collaborate in collecting and publishing data on the comparative effectiveness of GreenLight XPS for high-risk patients to supplement the currently limited published evidence.

  • 1.3
    Cost modelling indicates that in non-high-risk patients, cost savings with GreenLight XPS compared with TURP are determined by the proportion of procedures done as day cases. Assuming a day-case procedure rate of 36%, and that the GreenLight XPS console is provided at no cost to the hospital (based on a contracted commitment to fibre usage), the estimated cost saving is £60 per patient. NICE’s resource impact report estimates that the annual cost saving for the NHS in England is around £2.3 million. In a plausible scenario of 70% of treatments being done as day cases, the cost saving may be up to £3.2 million.
  • 1.4
    NICE recommends that hospitals adopting GreenLight XPS plan for service redesign to ensure that day-case treatment can be delivered appropriately.
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Podcasts Made Simple

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The other day we were listening to a podcast of a surgical technique; sadly, it sounded like a report from the BBC’s war correspondent in Afghanistan. The static was considerable and the recording of poor quality, as if transmitted by radiophone from a remote part of the world.

In keeping with our pledge to improve the quality of the BJUI, we present here a simple method of recording and submitting podcasts of the highest quality from your home or office. The results are obvious on bjui.org, where you can listen to a 60-second podcast on successful podcasting, in the BJUI Tube section. We encourage authors who have had their papers accepted to try this simple trick. We look forward to receiving your podcasts, which may enhance your articles in the right circumstances.

If you use an iPhone you should select the preinstalled ‘Voice Memo’ app. Similar apps are available for Android and other systems.

Simply tap ‘record’ when you are ready and start talking. Remember to breathe normally and speak in an even tone.

Once you are happy with your recording, simply use the share button to submit the file to us using our editorial office email address: editorial.office@bjui.info

 

 

In this issue, the Article of the Month is by Cooperberg et al. who present an analysis of the lifetime cost-utility of treatments for localised prostate cancer. This is a timely and controversial paper with an accompanying editorial from Pickard and Vale, who have been involved in a number of Health Technology Assessment. Cost-effectiveness ratios are now as important as clinical effectiveness although it does not necessarily mean that cheaper is always better. You can also enjoy a YouTube video provided by the authors to accompany their article in the BJUI Tube section of our website. To promote immediacy, we request you to add your comments to Blogs@BJUI. These will eventually replace the current section entitled Letter to the Editor. The debate needs to be topical and timely and not a year on when hardly anyone can remember what the original fuss was all about.

Prokar Dasgupta
Editor-in-Chief

Matthew Bultitude
Associate Editor, Web

 

Disclaimer: The BJUI does not support any particular smart phone. That choice is entirely up to our readers. Who knows, you may even decide not to have one, hence here is the paper version of our simple trick.

Face-to-Face with John Fitzpatrick

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An interview with John M. Fitzpatrick
BJUI December 2012, Volume 110, Issue 11

‘Face to Face’ is an interview with personalities in the urology field. As a successor to BJUI’s ‘Conversations’ feature, ‘Face to Face’ is fashioned after the highly acclaimed BBC television series of the same name where former British politician John Freeman interviewed famous men and women with an insightful and probing style.

In this edition of ‘Face to Face’, BJUI Associate Editor Roger Kirby (and a former ‘Face to Face’ interviewee), turns the tables and interviews John M. Fitzpatrick, MCh, FRCSI, FEBU, FRCS, in honour of 10 years of service as outgoing Editor-in-Chief of BJUI. After serving for 25 years as Professor and Chairman of the Department of Surgery at Mater Misericordiae Hospital in Dublin and University College Dublin, where he also received his medical school training, John is now head of research at the Irish Cancer Society. His list of medals, awards, prizes, and honorary degrees are simply too numerous to mention. This year, he was named Honorary Fellow of the Urological Society of Australia and New Zealand and received the Distinguished Career Award from the Société Internationale d’Urologie. His visiting professorships, invited lectures, and charitable work has taken him to the four corners of the world.

Please use the controls below to listen to the podcast:

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Managing Benign Prostatic Hyperplasia in primary care

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There are many guidelines available to primary care practitioners covering the management of BPH. Yet despite the plethora of help there is still a lot of confusion regarding the best way to manage this disorder. The article by Kirby et al in September 2009’s BJUI helps to unravel the confusion covering a number of points and promotes a ‘shared care’ approach working collaboratively with GPs.

Please use the controls below to listen to the podcast:

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