Learn About Aquablation

Overview

Aquablation is a procedure used to treat benign prostate hyperplasia, which means a non-cancerous, enlarged prostate. Aquablation uses a high pressure water jet to remove a portion of the prostate gland. Aquablation may also be used as an added treatment for some patients with prostate cancer to treat urinary retention or a urinary obstruction.

Aquablation is approved by the FDA for the treatment of benign prostate hyperplasia and is usually covered by insurance. Aquablation is proven to be safe and effective and can provide similar or better results than transurethral prostate resection, also called TURP. Most patients (90%) with benign prostate hyperplasia treated with Aquablation experience significant improvement.

Aquablation is performed by doctors called urologists, who specialize in treating diseases and disorders of the urinary system. Urologists have completed medical school, an internship, and a residency in the specialty of urology. Urologists who perform Aquablation therapy work under the supervision of experienced urologists before performing the procedure on their own.

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Who should receive aquablation?

Before undergoing aquablation, patients will be evaluated by an anesthesiologist. An ultrasound will be ordered to provide a clear picture of the area where the urologist will be working. Before the ultrasound, an enema will be given to empty the bowel. Any blood thinners a patient may be taking have to be stopped before the procedure. A urinary catheter will be placed through the urethra into the bladder. The catheter is removed after the procedure.

What are the details aquablation?

Aquablation is a short procedure performed under anesthesia in a hospital, and usually takes less than an hour. Aquablation can be used to treat patients with enlarged prostates from 25 to 150 grams. The prostate gland is divided into segments, such as the peripheral and the transition zone, which is located in the middle of the prostate. Benign prostate hyperplasia occurs in the transition zone. Removing 30 to 40 percent of the prostate during aquablation opens up a channel through which urine can flow more freely.

What are the side effects of aquablation?

A common complication of aquablation can be bleeding. Some patients with larger prostate glands may be treated with prostate artery embolization before aquablation to decrease the amount of bleeding.

After aquablation, patients may experience some burning pain and some blood in the urine for about two weeks.

After aquablation, patients should avoid heavy lifting and strenuous activities, such as bike and horse riding, or bumpy rides, such as in a golf cart. Patients may resume sexual activity one week after the procedure.

What is the comparison to similar treatments?

In comparison to transurethral prostate resection, also called TURP, aquablation has a greatly reduced rate (15%) of retrograde ejaculation, which is a complication where the semen goes into the bladder. In contrast, transurethral prostate resection has around a 70% rate of retrograde ejaculation as well as higher rates of erectile dysfunction.

Aquablation is a newer therapy approved to treat benign prostate hyperplasia. Various other therapies are available, such as medical therapy with finasteride and tamsulosin, transurethral prostate resection (TURP), balloon dilation, microwave therapy, needle ablation with radiofrequency, laser therapy, and others. In contrast to those treatments, aquablation offers patients a minimally invasive treatment that is 90% effective, with sustained results. After 10 years, only 10% percent of patients treated with aquablation may need further treatment or surgery.

Conclusion

It is important to ask your doctor how many aquablation procedures they have performed and what their success and failure rates may be. Patients with benign prostate hyperplasia should discuss all treatment options with their doctor.

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What are the latest Aquablation Clinical Trials?
WATER III: A Randomized, Controlled Trial of Aquablation vs. Transurethral Laser Enucleation of Large Prostates (80 - 180mL) in Benign Prostatic Hyperplasia

Summary: Comparative analysis of efficacy and safety of Aquablation (AQUABEAM Robotic System®, PROCEPT BioRobotics, Redwood City, CA, USA) and transurethral laser enucleation as surgical therapy for benign prostatic hyperplasia with large prostates (80-180ml).

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Aquablation vs. Holmium Laser Enucleation of the Prostate in the Treatment of Benign Prostatic Hyperplasia in Medium to Large Size Prostates: A Prospective Randomized Trial

Summary: Benign prostatic hyperplasia (BPH) is one of the most common diseases in men. As BPH progresses, surgical treatments often become necessary. Holmium enucleation of the prostate (HoLEP) is an established procedure in the surgical treatment of BPH, especially for medium to large prostates. The long learning curve, the length of surgery, and expensive equipment still limit the availability of HoLEP t...

What are the Latest Advances for Aquablation?
Technique, outcome and changes in prostate dimensions in patients with urinary retention managed by aquablation.
WATER vs WATER II 3-Year Update: Comparing Aquablation Therapy for Benign Prostatic Hyperplasia in 30-80 cc and 80-150 cc Prostates.
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Initial Experience Performing "Cautery-Free Waterjet Ablation of the Prostate".