For many men, having an enlarged prostate is a normal part of aging. This process starts around the age of 40 and by the time they turn 60, about half of men have this condition.
Many of these men aren’t even aware it’s happening, and for them no treatment is necessary. But others start to wake up frequently at night to use the bathroom, can’t fully empty their bladder or experience other urinary symptoms.
For men whose problems are moderate or severe, the use of surgery or lasers to remove some of that prostate has long been an option. But the use of heat brings risks, including erectile dysfunction.
A new option called Aquablation cuts down on those risks because it uses room-temperature water, not heat. It uses computer-guided technology to remove a precise amount of tissue limiting the side effects of traditional treatment such as transurethral resection of the prostate (TURP), greenlight laser or microwave thermotherapy.
Aquablation works by mapping out the area to be treated using images from an ultrasound and sends these pictures to a computerized robotic system to precisely guide the waterjet to incise the tissue only where we want to cut.
“It’s tailor-made to fit the exact size of each prostate,” AdventHealth urologist Michael McDonald, MD said of the procedure. He started doing it in March and says its speed — the whole procedure takes less than an hour — and its relative lack of side effects have quickly made it an attractive alternative to regular surgery.
If you’re experiencing the signs of an enlarged prostate, it helps to know what’s going on.
What Is BPH?
The prostate is a ping pong ball-sized gland that makes a fluid that forms part of semen. The prostate surrounds the urethra, the tube that carries urine out of the bladder.
The technical term for an enlarged prostate is “ benign prostatic hyperplasia ,” or BPH. It’s called “benign” because it’s not cancerous.
But it can cause problems. According to the National Institute on Aging, prostate problems include the following:
- Blood in Urine or Semen
- Dribbling of Urine
- Frequent Pain or Stiffness in the Lower Back, Hips, Pelvic or Rectal Area or Upper Thighs
- Frequent Urge to Urinate
- Need to Get Up Many Times During the Night to Urinate
- Painful Ejaculation
- Pain or Burning Urination
These could be warning signs for prostate cancer, too, so it’s important to get them checked out. Even if cancer is ruled out, you may still want to pursue symptom relief. That’s where Aquablation could come in.
How Does Aquablation Work?
Its name provides a clue: It combines “aqua,” or water, with “ablation,” the surgical removal of tissue.
It starts by creating a detailed image of the prostate and the area around it. Using these pictures, the surgeon programs the robot to remove a set amount of tissue.
“You can go as deep, wide or long as you think is necessary,” Dr. McDonald said. “Every procedure is going to be different based on the size and position of the prostate.”
The robot is autonomous, meaning once it’s programmed it acts on its own. This allows it to be precise and quick — the treatment itself lasts only about five minutes. The longest part of the procedure involves taking pictures and deciding what to remove, but all told it only takes 30 to 45 minutes, he said.
Dr. McDonald said it’s also effective, with patients saying their symptoms eased up afterward. Because the treatment is so new, long term data is not yet in. However, two-year data at this time shows marked improvement of symptoms with the lack of side effects of traditional therapy.
At this point, we offer Aquablation in the hospital because we want to observe patients overnight. At some point, we may be able to offer it in a same-day surgery center.
Aquablation is an option for most men with enlarged prostates, Dr. McDonald says. It wouldn’t be recommended for men with prostate cancer or a number of other bladder conditions.
Even though having an enlarged prostate isn’t life-threatening, whole-person health is our focus, so we take these quality-of-life concerns seriously. Aquablation is a new option that may help you find relief while avoiding the risks of traditional surgery.
To find out if you’re a candidate for Aquablation, contact Dr. McDonald’s office to learn more.