HWN Suggests

Aquablation of the prostate for the treatment of lower urinary tract symptoms in men with benign prostatic hyperplasia

Minimally invasive surgery for BPH is a dynamic field, with novel treatment modalities emerging in experimental and clinical use with various safety and efficacy profiles. Aquablation is a new technology in terms of treatment of BPH, and reported experimental and clinical initial results suggest it is efficacious and well‐tolerated. However, it is unclear whether Aquablation actually translates into more clinical benefits and fewer adverse events in clinical practice compared to conventional surgical treatment.

read full article

Featured

 Aquablation: An overview of a novel, minimally invasive surgical modality to treat benign prostatic hyperplasia

Aquablation offers clear advantages. First, it can be done under general or spinal anesthesia and can therefore be offered to comorbid patients, provided that they do not have any absolute contraindications. The technique is heat free and robotic assisted for precision, thereby limiting the damage to adjacent structures, such as the ejaculatory ducts, that can lead to EjD. Excellent outcomes are observed in most patients regardless of their prostate size and, as such, may be suitable as a first-line option to treat their BPH.

Articles of Interest

To the Men Out There: Is Aquablation Right for You?

Aquablation therapy is an endoscopic surgery that uses an image-guided, surgical robotic system that combines multidimensional imaging, automated robotics and waterjet ablation (surgical removal). Dr Lee explains: “With aquablation therapy, no incision is made in the abdomen because the prostate is reached through the urethra. The surgeon remains in control at all times of an image-guided robotic arm that delivers a heat-free jet of water that precisely removes the prostate tissue causing the symptoms.”

Will Aquablation Be the New Benchmark for Robotic Minimally Invasive Surgical Treatment for Benign Prostatic Hyperplasia?

Aquablation is a valid alternative to standard resection techniques, showing excellent long-term functional outcomes, good preservation of sexual function, a good safety profile, and good compliance for all prostate sizes and patient ages. Aquablation is still performed in high-volume centers, but the results can easily be emulated in other centers worldwide.

Aquablation in men with benign prostate hyperplasia: A systematic review and meta-analysis

Aquablation seems to improve lower urinary tract symptoms in men with BPH while providing relatively preserved sexual function. Further research is required to confirm these preliminary results. Aquablation was initially described in 2015 and is a minimally invasive surgical intervention that combines programmed robotics and imaging guidance for the treatment of LUTS secondary to BPH by removing hyperplastic prostate cells. While still considered a minimally invasive procedure, Aquablation is performed in the lithotomy position under general anesthesia.[

Aquablation robotic therapy for lower urinary tract symptoms caused by benign prostatic hyperplasia

Aquablation therapy against standard care, including TURP, there is a need for further comparative studies comparing Aquablation therapy with other technologies used in current practice, such as holmium laser enucleation of the prostate. Relative to similar technologies for this indication, the total number of studies is small. But there are a number of ongoing studies which may address gaps in the current evidence base.

Aquablation therapy for BPH

In global clinical studies, men who had prostates larger than 50g, Aquablation therapy was shown to have superior outcomes compared to the standard of care for symptom relief. Men with Aquablation had a very low rate of irreversible complications – incontinence, ejaculatory dysfunction, erectile dysfunction.

Aquablation: a novel and minimally invasive surgery for benign prostate enlargement

Aquablation is a minimally invasive surgical technology for benign prostate enlargement, which uses high-pressure saline to remove parenchymal tissue through a heat-free mechanism of hydrodissection. Early results show this to be a promising surgical strategy with a strong morbidity profile and reduced resection time.

WATER versus WATER II 2-Year Update: Comparing Aquablation Therapy for Benign Prostatic Hyperplasia in 30–80-cm3 and 80–150-cm3 Prostates

Aquablation therapy clinically normalizes outcomes among patients regardless of prostate size or shape. The advantages of Aquablation, namely short operative times and smooth learning curves for clinical outcomes, are comparable for both small-to-moderately-sized and large prostates. These findings suggest that the effectiveness of Aquablation is independent of prostate size and that outcomes are durable for up to 2 yr of follow-up.

Waterjet ablation offers minimally invasive option for BPH

Over the past several years, urologists and men suffering from BPH have been introduced to a growing number of alternatives for managing this disease. In addition to the gold-standard transurethral resection of the prostate (TURP) and the simple prostatectomy (for larger prostates), urologists can now present men with symptomatic bladder outlet obstruction a variety of newer management options including UroLift and Rezum for prostate volumes 30-80 grams. In clinical practice, some urologists are also performing these procedures in men with prostates >80 grams.

Resources

Aquablation.com

You’ve given medications a shot, and now you’re considering other options. Aquablation therapy is an advanced, minimally invasive BPH treatment that uses the power of water delivered with robotic precision. It’s a long-lasting solution with low rates of irreversible complications, giving you the confidence to live life on your terms.

Prostate Matters

The procedure is usually done with the patient under general or spinal anaesthesia, whilst the treatment time is usually less than 10 minutes, the set up and real time ultrasound guided planning mean that the whole procedure takes about 45 minutes.