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    The PLASMA system for transurethral resection and haemostasis of the prostate

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    1 Recommendations

    1.1 The evidence supports the case for adopting the PLASMA system for bipolar transurethral saline resection and haemostasis of the prostate in the NHS. Clinical outcomes are the same as for monopolar transurethral resection of the prostate (mTURP), but PLASMA avoids the risk of transurethral resection syndrome and reduces the need for blood transfusion and the length of hospital stay.

    1.2 The PLASMA system for prostate resection and haemostasis should be considered as an option for people with symptomatic benign prostatic hyperplasia when surgical intervention is indicated.

    1.3 Cost modelling estimates that the PLASMA system is cost saving by £459 per procedure compared with mTURP for hospitals that already use an Olympus platform and £343 for those that do not. This assumes a reduced (2-day) length of stay with PLASMA and that 65% of procedures need a second electrode for haemostasis. Evidence suggests there are reduced readmissions with the PLASMA system compared with mTURP. This would increase cost saving to £534 for hospitals that already use an Olympus platform and £418 for those that do not.

    Why the committee made these recommendations

    The PLASMA system uses electrodes to cut out (resect) prostate tissue and stop any local bleeding afterwards (haemostasis). The electrodes are put into the prostate through the urethra (transurethral). It is a treatment for symptomatic benign prostatic hyperplasia.

    The clinical evidence supports using the PLASMA system (which used to be called TURis) for TURP. Clinical outcomes are as good as for conventional mTURP but there is a lesser chance of serious complications. PLASMA also reduces the length of hospital stay. This means that the treatment costs are less than for conventional mTURP.