New procedure offers a less invasive option for treatment of enlarged prostate

By the time men reach the age of 60, nearly half will experience prostate enlargement. By age 85, the likelihood increases to 90%, according to the National Association for Continence. This condition, known as benign prostatic hyperplasia, or BPH, affects millions of men as they age.

An enlarged prostate can lead to bothersome urinary symptoms as it blocks the flow of urine out of the bladder. Symptoms may include frequent urination, weak urine flow, difficulty starting or stopping urination, and the need for nighttime trips to the bathroom. Sometimes the impact can be more serious, resulting in bladder, urinary tract or kidney problems.

Aquablation therapy is a new minimally invasive procedure performed by urologists to relieve lower urinary tract symptoms caused by BPH. It uses a combination of real-time imaging, robotics and a high-pressure water jet to remove excess prostate tissue that blocks urine flow. Treatments are tailored to each patient’s anatomy, including those with larger prostates.

When compared with traditional surgical treatments for BPH, aquablation offers several advantages:

There are no incisions as it is performed through the urethra.
The risk for complications, such as tissue injury leading to sexual dysfunction, may be lower as heat is not used.
Erectile and ejaculatory function preservation rates are high in clinical studies when compared with traditional procedures.
The procedure can treat a wide range of prostate sizes, including glands that may be too large for some other minimally invasive options.
It is a same-day procedure for many patients, though some require an overnight stay.

During the procedure, surgeons use ultrasound imaging and a small camera to create a customized treatment map based on the patient’s anatomy. A robotically controlled, heat-free water jet accurately follows the treatment map to remove only the tissue causing obstruction, preserving surrounding structures.

Aquablation therapy is performed under anesthesia and is typically completed in about an hour. Many patients can urinate on their own shortly after treatment, though a temporary catheter may be needed during early recovery. The most common side effect is mild burning during urination for a short time.

Most patients notice an improvement in urinary symptoms within weeks. Recovery is generally faster and patients typically experience fewer sexual side effects compared with traditional surgical options. Risks such as bleeding or infection are possible, but serious complications are uncommon. Patients can resume their normal activities once approved by their doctor.

Aquablation may be a good option for men with moderate to severe BPH symptoms who have not found relief with medication or who want an alternative to traditional surgery. A urologist can help determine whether aquablation is appropriate based on prostate size, symptom severity and overall health.

This precise approach to treating enlarged prostates gives urologists a new option to offer eligible patients as they work to help men restore function and return to more comfortable, active lives.

Sam Engelsgjerd, MD, is a urologist on staff at ProHealth Care. ProHealth Waukesha Memorial Hospital is the first hospital in the Milwaukee area and one of only two hospitals in the state to use the HYDROS Robotic System for aquablation therapy, from PROCEPT BioRobotics.