Health

Tiny spring to tackle prostate problems

Millions of men are affected by an enlarged prostate
Roger Dobson

A tiny spring could help ease symptoms of an enlarged prostate, which affects millions of men.

The spring, roughly the size of a paperclip, is implanted under local anaesthetic and then expands to prop open the urethra, the tube urine passes through, which narrows when the prostate enlarges, causing problems going to the loo.

More than half of men over 50 have benign prostatic hyperplasia (BPH), a condition in which the prostate - a small gland in the pelvis - becomes enlarged (often as part of the ageing process), narrowing parts of the urinary tract.

This causes a range of uncomfortable symptoms, such as frequent trips to the loo and difficulty in fully emptying the bladder.

It is estimated that three million men have urinary tract symptoms as a result of BPH.

Treatment involves lifestyle changes, such as consuming fewer fluids in the evenings, as well as medication or surgery.

However, the medications, called 5-alpha reductase inhibitors (which reduce the size of the prostate) and alpha blockers (which relax the bladder), can take months to be effective and can have side-effects, including loss of libido.

Meanwhile, surgery to trim the excess prostate tissue, known as transurethral resection of the prostate, requires a general anaesthetic and has risks such as incontinence or impotence.

Now researchers are trialling a different option which they hope will have little or no side-effects - a spring that opens the urethra to let urine pass through freely.

The Zenflow Spring System is made from an alloy of nickel and titanium called nitinol.

It is a shape-memory metal, meaning it can 'remember' its original spring or coil shape after being compressed.

In a 10-minute procedure under local anaesthetic, the spring is flattened and loaded into a catheter - a thin, flexible tube - with a camera on the end, and inserted into the urethra. It is guided into place where the urethra is restricted - and then released.

Once exposed to body temperature, the metal 'remembers' its original spring-like shape and expands, pushing back the prostate tissue and propping the urethra open.

According to a study in the World Journal of Men's Health last year, the first reports from men who have had the implant fitted suggest it is effective and safe.

"Early clinical cases show a low rate of side-effects, fast recovery and durable results," it said.

Now hundreds of men are taking part in five clinical trials to see if the implant - which is designed to be permanent, although it can be removed if necessary - helps with BPH symptoms.

One multi-centre study involving 279 patients, led by the University of Texas Southwestern in the United States, is investigating its effects compared to a placebo procedure, where no spring is implanted.

Another trial of 40 men at Toronto Western Hospital, Canada, will look at its effects on urinary tract symptoms, including difficulty passing urine.

Professor Raj Persad, a consultant urological surgeon at Southmead Hospital in Bristol, said: "This seems a good temporary solution particularly for those who are unfit for, or do not want, surgery. Although this is an improved material, experience in the past shows that stents can become encrusted or erode tissue."

© Daily Mail

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