Expert comments

Comments on this technology were invited from clinical experts working in the field and relevant patient organisations. The comments received are individual opinions and do not represent NICE's view.

All 3 of the experts have used this technology before to do procedures.

Level of innovation

All of the experts agreed that the technology provides a minor variation on an existing procedure, which is unlikely to alter the procedure safety or efficacy. One of the experts mentioned that the PLASMA system with button electrode is novel in that the prostate tissue is vaporised, rather than resected. Another expert explained that there is reduced risk of bleeding because the technology is targeted at people with a smaller prostate volume.

Potential patient impact

Two experts stated that the PLASMA system with button electrode has a reduced complication profile and allows a shorter hospital stay. Also, the learning period for clinicians is likely to be fast because of similarities with TURP. The other expert said that TUVP has similar postoperative outcomes for patients compared with either TURP or open prostatectomy based on the evidence.

Potential system impact

All of the experts agreed that there would be system benefits of adopting the PLASMA system with button electrode for vaporisation of the prostate, reducing the number of bed days and reattendance in emergency services. One expert said that there would be fewer complications needing management and shorter theatre time, resulting in increased theatre efficiency. Another expert stated that, compared with standard TURP and open prostatectomy, there would also be a reduction in catheterisation time.

General comments

All of the experts outlined that the cost of the new procedure should be similar to standard care, adding that there may be an initial outlay for centres that do not already use the PLASMA system. The experts also explained that no extra staff would be needed and that minimal training from the company would be enough for clinicians who are already using PLASMA for TURP. One of the experts highlighted that there had been no mention of erectile dysfunction, which is a key patient concern when selecting the most appropriate procedure for benign prostatic hyperplasia.