Aquablation Therapy Improves Quality of Life for Men with Enlarged Prostates, Urinary Symptoms
By Amy Morgan
Many mid-life men know the symptoms of enlarged prostate — the urgent need to go to the bathroom frequently and difficulty urinating once they get there. In fact, by the age of 50, one of every two men already experiences Benign Prostate Hyperplasia (BPH) a non-cancerous condition that causes urinary problems. Because the gland continues to grow throughout a man’s life, 90% of men older than 80 will eventually be affected by BPH. If left untreated, BPH can cause significant health problems, including irreversible bladder or kidney damage, bladder stones, urinary tract infection (UTI) and incontinence.
Traditionally, the condition has been treated with medication or surgery, the effectiveness of which can be limited by prostate size and can involve unpleasant side effects. A newer therapy, Aquablation, was perfected several years ago and offers greater flexibility and fewer undesirable risks to, among other things, sexual function. The Baptist Health System is delighted to announce the unveiling of their new AquaBeam Robotic System at North Central Baptist Hospital in Stone Oak, allowing trained urologists to begin performing Aquablation therapy on site this November.
Aquablation therapy is an innovative, minimally invasive treatment that combines real-time, multi-dimensional imaging, automated robotic technology and heat-free waterjet ablation for targeted, controlled and immediate removal of excess prostate tissue. Because heat isn’t involved with the treatment, Aquablation has less effect on the structures around the prostate, helping to preserve sexual function in most patients.
“The availability of Aquablation allows for patients to have the full spectrum of options available to treat their BPH,” said George Vassar, M.D., who practices with Urology San Antonio. Dr. Vassar has performed surgery at North Central Baptist for more than 20 years. “I’m excited to be able to offer this state-of-the art treatment to my patients for their disease at my home facility.”
Aquablation addresses urinary symptoms like urgency and week urinary stream in a novel new way, agreed Ahmad Azzawe, M.D., who practices with Alamo Urology. Other BPH surgical treatments often force men to compromise between symptom relief and side effects. Patients choosing a high degree of symptom relief face possible complications such as incontinence, erectile dysfunction or ejaculatory dysfunction.
“Many of the tools have been around for years, but side effects are always a balance,” Dr. Azzawe said. “Transurethral Resection of the Prostate (TURP) surgery has been the gold standard, but sexual side effects can come into play. The things that preserve sexual function may not last as long. Aquablation provides the best of both worlds.”
Urologic surgeons like Dr. Vassar and Dr. Azzawe perform the minimally invasive Aquablation therapy in the hospital using the AquaBeam Robotic System. While the patient is under general anesthetic and asleep, the treatment area is mapped via ultrasound to provide live-time images that pinpoint the tissue to be removed.
Aquablation therapy is the first and only (as of October 2020) BPH procedure to simultaneously combine the standard camera, called a cystoscope, with ultrasound guidance imaging, giving the surgeon the ability to see the entire prostate in real time.
Picture the neck of a balloon being squeezed from the outside to visualize how an enlarged prostate, normally the size of a walnut, strangles the small urethral tube.
Because every prostate is unique in size and shape, Aquablation therapy’s advanced technology allows the surgeon to respond to each patient’s specific anatomy. No incision is necessary. The surgeon guides a scope with the AquaBeam jet of water and camera through the inside of the urethra directly to the area where the prostate has constricted the urethra’s connection to the bladder. A robotic arm locks in the parameters to ensure only the offending tissue is removed.
The excess tissue melts away under the pressure of the water, relieving the bottleneck that has been constraining the bladder and urethra and causing difficulties urinating.
Aquablation typically takes around 1 to 1.5 hours and may involve an overnight stay depending on the size of the prostate. Image guidance also allows preservation of the area that controls ejaculatory function – previously at risk with other treatment.
“For a lot of men preservation of sexual function is something personal,” Dr. Azzawe said. “The loss of any of those functions can be lifechanging. Most prefer not to have their sexual function impaired.”
“Aquablation outcomes are comparable to the gold standard TURP that’s been around for decades,” Dr. Vassar agreed. Another advantage, the robotic platform allows for the removal of larger amounts of tissue than traditional prostate surgery, meaning larger glands can be treated in a shorter amount of time, he added.
“There’s high demand for technology like this. It is a great opportunity to have this tool to give more men in this city the benefit of full treatment,” Dr. Azzawe added.
The Baptist Health System is proud to provide greater access to this technology to allow men in San Antonio further options to treat their urinary symptoms so they can get back to feeling like themselves again.