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

For most men, the unfortunate reality of aging means most will develop an enlarged prostate after age 50. In fact, an enlarged prostate—medically known as benign prostatic hyperplasia (BPH)—is the most common reason men visit the urologist.

“Benign prostatic hyperplasia affects about half of all men between ages 51 and 60. Up to 90 percent of men over age 80 have it,” says Dr. John Lee, a board-certified urologist with Lee Health Urology. “The symptoms of BPH often cause significant quality of life issues, and if left untreated, BPH can cause health problems, including irreversible bladder or kidney damage, bladder stones, and incontinence (loss of bladder control).”

At Lee Health, a new, advanced treatment for BPH called aquablation therapy can help preserve a patient’s sexual function and offer a faster, smoother recovery. Dr. Lee helps explain how aquablation therapy works and whether it might be the right BPH treatment option for you.

What is benign prostatic hyperplasia (BPH)?

“Benign prostatic hyperplasia, which affects only men, occurs when the prostate gland enlarges from no cancerous growth,” Dr. Lee says. “It’s a common condition associated with aging. As the prostate enlarges, the gland presses against and pinches the urethra, which can bother or block the ability of the bladder to pass urine or empty it fully. In most men, BPH gets worse with age.”

In moderate to severe cases of BPH, Dr. Lee says when medications or behavioral modifications fail to provide symptom relief, surgery may be a treatment option.

“It becomes a quality-of-life issue, at this point,” he says. “If you’re getting up multiple times during the night to urinate or have to worry about where a bathroom is after leaving your home, that can make life miserable. Not to mention BPH can affect your quality of sleep, too. Surgery becomes a consideration because we can open the prostate to allow you to urinate better, thus providing symptom relief.”

What is aquablation therapy, and how can it help relieve BPH symptoms?

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.”

Compared to traditional surgical options, aquablation therapy limits potential side effects and speeds up their recovery, Dr. Lee says, especially in men with very large prostates.

“The tissue is removed using room-temperature saline water. Because there’s no heat used in the procedure, we can fix the blockage without harming the outside of the prostate, where the nerves are for erections. Some surgical prostate therapies use heat that can harm these nerves, possibly causing sexual dysfunction after the procedures.”

He adds that saline water, a mixture of salt and water, is biocompatible with the human body.

Studies have shown the therapy helps preserve erectile and ejaculatory function. There’s also a low incontinence rate (loss of bladder control) associated with aquablation therapy.

“The risk of being unable to ejaculate after aquablation therapy is about 10 percent compared to a 50 percent to 90 percent risk with other approved surgical approaches to treat BPH,” Dr. Lee notes.

The procedure, performed while the patient is under anesthesia in an operating room, typically takes less than an hour, about half as long as traditional BPH surgeries. An overnight stay is often required. However, depending on the size of the prostate, the patient may be allowed to go home on the same day of treatment.

“Aquablation therapy is an excellent example of personalized medicine,” Dr. Lee says. “Every prostate is unique in size and shape, so it’s important for me to customize the surgery to my patient’s specific anatomy. It’s the only procedure that combines a camera (called a cystoscope) with ultrasound imaging, giving me the ability to see the entire prostate in real-time in different visual planes.”

He notes that, as with most BPH procedures, afterward, you’ll wake up with a catheter, which allows you to urinate while your urethra heals.

“Patients typically stay overnight, and the catheter is removed two days after they’ve been discharged. Afterward, some patients may experience mild burning during urination for a few days, which can be managed with mild pain medication,” Dr. Lee explains. “The flow of urine improves immediately, and symptoms such as waking up at night to urinate and having to go frequently improve significantly as the prostate heals. Within six weeks of the surgery, patients enjoy excellent symptom relief and can expect to stop taking medications for urinary symptoms.”

Ready to take the next steps?

Are you wondering if you’re a candidate for aquablation therapy? For a consultation or to schedule an appointment with a Lee Health physician, visit our website here.