Current evidence on the safety and efficacy of laparoscopic prostatectomy for benign prostatic obstruction (BPO) is inadequate in both quantity and quality. Therefore, this procedure should only be used with special arrangements for clinical governance, consent and audit or research.
Clinicians wishing to undertake laparoscopic prostatectomy for BPO should take the following actions.
Inform the clinical governance leads in their Trusts.
Ensure that patients understand the uncertainty about the procedure's safety and efficacy, make them aware of alternative treatment options and provide them with clear written information. In addition, use of NICE's information for the public is recommended.
This procedure should only be carried out by surgeons with special training and experience in laparoscopic radical prostatectomy. The British Association of Urological Surgeons (BAUS) has produced training standards.
Patients should only be offered this procedure if they would otherwise be considered for open prostatectomy, rather than transurethral resection, for BPO.
Clinicians should submit data on all patients who receive this procedure to the BAUS Cancer Registry & Sections Audit.
NICE may review the procedure on publication of further evidence.