Prostate cancer patients are being put at risk by surgeons who lack regular practice and expertise, a leading consultant has claimed.

Many surgeons perform only a small number of keyhole operations a year, leaving patients vulnerable to complications such as incontinence and impotence as a result.

Christopher Eden, of the Royal Surrey County Hospital in Guildford, said that surgeons needed to carry out hundreds of operations before perfecting their technique for the complete removal of the prostate. Writing in the British Journal of Urology, Mr Eden, who has completed a thousand such operations, said: “The learning curves demonstrate that it takes 100 to 150 cases to achieve proficiency. It takes 200 to 250 cases for complications and continence but 700 cases for potency. Given that most surgeons will not do 700 prostatectomies in their entire career, this makes a powerful argument for limiting complex surgery to high-volume surgeons.”

His claims are backed up by the National Institute for Health and Clinical Excellence (NICE), which insists that radical prostatectomy should not be done by teams who carry out fewer than 50 a year, and surgeons who do fewer than five a year should stop altogether. But NICE reported in February that this “key recommendation” was frequently ignored and that more than half still did fewer than ten operations annually.

“Patients need to be aware of how proficient their surgeon is,” said Mr Eden, who also operates at the BMI Hampshire Clinic in Basingstoke.

— Scientists have developed a genetic test to detect prostate cancer. The urine test for the PCA3 gene reveals the size and development of the disease and will be of particular help to men with low-grade cancer.

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