For radical prostatectomy:

• Am I an ideal patient for this surgery and if not, why not and how does this affect the predicted outcomes?
• What results does your consultant think they can deliver for the ‘trifecta’ of incontinence, quality of erections and cancer cure?
• How do they collect their results? Can you see them?
• What’s the expected recovery time and how long will the catheter stay in?
• Has the surgeon had patients with bowel injury/ fistulas and if so, how often?

For Greenlight laser therapy/ Aquablation therapy/ TURP/ PAE/ HoLEP

• How often are your consultant’s patients pleased with the outcome?
• What issues might occur that may leave you disappointed in the long term?
• How often is the recovery period without issues?
• What sort of post-operative issues can occur to slow down recovery?
• How often is another procedure needed in the next 5 years?

For a prostate biopsy

• Is there a lesion that’s visible on the MRI?
• What are the likely pain levels during the procedure?
• How often is the prostate under-sampled at biopsy, and how was this measured?
• How often does an infection develop following a biopsy?
• How often do patients need catheterisation post-biopsy?
• What method of targeting is being used?

For focal therapies

• Who’s the team that will deliver the treatment and will there be an experienced radiologist doing the contouring?
• Does the equipment come with an experienced technician?
• Has or will your case be discussed in a specialist focal therapy meeting?
• Is your lesion an ideal case for focal therapy and if not, what are the concerns?
• How often does the one-year MRI surveillance scan show no residual cancer in the treated area?

For prostate radiation therapy

• Are you an ideal candidate for radiation treatment? If not, why not?
• How often do patients get long-term bothersome bowel and urinary symptoms, and how is this assessed?
• How often are patients seriously bothered by the side effects of hormone therapy and what sort of symptoms do they experience?
• How often does the PSA start to rise after radiation treatment, resulting in the need for additional treatments?
• What are the common salvage treatments?

Some BPS results by procedure

We have gathered some results and we’re currently updating these in a new study, which we expect will show further improvements.

Radical proctectomy 

Not all patients start with the same risk of cancer, levels of health or urinary and/ or sexual function.

An ideal patient is one who has few comorbidities, hasn’t had a previous prostate procedure, has perfect erectile function and has a low/ intermediate cancer risk.

About 15% of patients that we see at BPS meet these criteria and for these, the risks we quote are:

• 1% for bothersome incontinence - needing two or more pads a day and corrective surgery.
• 15% for non-bothersome incontinence – an occasional involuntary loss of a few drops of urine when straining, passing wind or sexually aroused.
• 60-80% for recovery of erectile function within 2 years (with or without the support of Viagra).

Focal therapy

In an uncomplicated patient who hasn’t had a previous procedure, the risk at BPS and the Focal Therapy Group is:

• 0.2% for bothersome incontinence needing two or more pads a day and corrective surgery.
• 15% for non-bothersome incontinence - a slight dribble when not peeing.
• 99% retain a good erection - with or without the support of Viagra.