What is Aquablation, and How Does it Address BPH?
Aquablation is an advanced treatment designed for benign prostatic hyperplasia (BPH), where the prostate gland becomes enlarged, leading to urinary difficulties. This procedure utilises a high-powered water jet, guided by robotic technology, to precisely remove excess prostate tissue, offering a modern alternative to traditional surgeries with potentially fewer side effects.
How Does the Aquablation Procedure Work?
Aquablation incorporates several cutting-edge technologies:
Real-Time Imaging for Precision
- Ultrasound Imaging: Provides continuous visual guidance during the procedure, ensuring accurate targeting of prostate tissue.
Robotic Assistance for Accuracy
- Robotic Arm: Controls the water jet with high precision, allowing for careful removal of prostate tissue while minimising damage to surrounding areas.
High-Powered Water Jet for Effective Treatment
- Water Jet Ablation: Uses a powerful water jet to efficiently remove excess prostate tissue, helping to reduce the size of the prostate and alleviate BPH symptoms.
What Are the Key Benefits of Aquablation?
Aquablation offers several notable advantages over traditional BPH treatments:
Minimally Invasive Nature
- Reduced Invasiveness: Compared to traditional surgery, Aquablation is less invasive, which typically results in quicker recovery times and less post-operative discomfort.
Preservation of Sexual Function
- Lower Risk of Sexual Side Effects: Aquablation is associated with a reduced risk of affecting sexual functions, such as ejaculation and erectile function, compared to some other treatments.
Reduced Risk of Incontinence
- Minimised Risk of Incontinence: The procedure’s precision helps avoid damage to surrounding tissues, which lowers the likelihood of developing incontinence (loss of bladder control).
What Does Clinical Research Say About Aquablation?
The WATER II trial is a significant study evaluating Aquablation's effectiveness for men with large prostates (80–150 cc). Key findings include:
Improvement in BPH Symptoms
- Symptom Relief: Patients experienced substantial improvement in symptoms, with average scores dropping from 23.2 (severe) to 6.5 (mild) over three years.
Enhanced Urinary Flow Rate
- Improved Flow: Urine flow rate nearly doubled, from 8.7 millilitres per second to 18.5 millilitres per second, indicating much more effective bladder emptying.
Long-Term Relief and Low Complication Rates
- Sustained Relief: After three years, 94% of patients were off BPH medication, and 97% did not require additional surgical interventions.
- Low Complications: Only 6% needed BPH medication, and 3% required further surgery within three years, with a low incidence of severe complications like incontinence and sexual dysfunction.
What Are the Alternative Surgical Treatments for BPH?
Several other surgical options are available for treating BPH, each with distinct benefits and limitations:
TURP (Transurethral Resection of the Prostate)
- Description: Removes prostate tissue using an electric current.
- Advantages: Effective for reducing prostate size.
- Disadvantages: Potential complications include sexual dysfunction and incontinence.
HoLEP (Holmium Laser Enucleation of the Prostate)
- Description: Utilises a laser to enucleate (remove) prostate tissue.
- Advantages: Suitable for various prostate sizes.
- Disadvantages: Requires specialised skills and may have a steep learning curve.
Rezum
- Description: Uses steam to ablate prostate tissue.
- Advantages: Minimally invasive.
- Disadvantages: May involve a longer recovery period.
iTINDT (Temporary Implantable Nitinol Device)
- Description: Temporarily compresses prostate tissue to widen the urethra.
- Advantages: Less invasive.
- Disadvantages: Typically offers only temporary relief.
Optilume
- Description: Involves a drug-coated balloon to dilate the urethra.
- Advantages: Opens the urinary channel without tissue removal.
- Disadvantages: Still under evaluation for long-term effectiveness.
Bladder Neck Incision
- Description: Small incisions at the bladder neck to relieve obstruction.
- Advantages: Suitable for men with smaller prostates or for a less invasive approach.
- Disadvantages: May be less effective for larger prostates.
Who Should Consider Aquablation?
Aquablation is recommended for men who:
- Have Moderate to Severe BPH Symptoms: Especially if they have not found relief from medications.
- Have a Large Prostate (80–150 cc): Proven efficacy for larger prostate sizes.
- Want to Avoid Traditional Surgery Risks: Including preservation of sexual function and minimised risk of complications.
- Are Concerned About Side Effects: Seeking a less invasive treatment option.
What to Expect Before, During, and After the Aquablation Procedure
Preparation
- Imaging: Patients undergo pre-procedure imaging to plan the treatment effectively.
During the Procedure
- Anaesthesia and Execution: Conducted under anaesthesia, with the robotic system guiding the water jet to remove prostate tissue.
Recovery
- Post-Procedure Care: Most patients experience a short hospital stay and can resume normal activities within a few days.
Why Choose Aquablation for BPH?
Aquablation represents a significant advancement in BPH treatment by offering a precise, minimally invasive solution with reduced risks and effective results. It is especially beneficial for men with larger prostates or those seeking a less invasive option that minimises complications.
Frequently Asked Questions (FAQs) About Aquablation
Is Aquablation Safe?
- Safety: Yes, clinical trials confirm Aquablation as safe with fewer complications compared to traditional methods.
How Long Does the Procedure Take?
- Duration: The procedure generally lasts about an hour, including preparation time.
Will I Need Additional Treatment?
- Follow-Up Care: Most patients experience lasting relief, a follow up is usually done two to three months from the surgery to assess your progress from the surgery. If you are well by then there is no need for further follow up.
