Posted , 31 users are following.
Occasionally here Aquablation has been mentioned. I was just reading about it and the reports say it is as effective as HoLEP and there are no reports of retro. Wondering if anyone here has had this procedure and if so how did it work out?
0 likes, 61 replies
We want the community to be a useful resource for our users but it is important to remember that the community are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the community is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.
mikemh tom86211
Edited
I have had it this summer
There is a lot of misinformation on this site. For example, the procedure certainly does NOT just take ten minutes. My recovery was very quick. The main issue is potential bleeding, but I was ok.
I have no RE and things look good.
The only issue was that the surgeon was too cautious, so I was left with a small bit of tissue fouling the urethra. This was removed during a subsequent cystoscopy
I think I have posted my experience somewhere on this site. But it seems to lose stuff
M
Motoman mikemh
Posted
Mike,
Did you have this done in the UK? I am in the US, and am looking into this procedure. How long does your Dr think the procedure will last? Did you pay out of pocket?
Thanks
rdemyan mikemh
Posted
Hi Mike:
When I said the procedure was typically less than 10 minutes, I was talking about actual "cutting" time. Apparently, with aquablation there is a relatively large amount of setup time since the procedure is robotically accomplished. I got my information from a study entitled "Waterjet ablation offers minimally invasive option for BPH" by Ali Kasraeian. Here is what he writes:
"From the surgeon’s perspective, a major advantage of this procedure in my opinion is the short learning curve and reproducibility of technique from one case to another. During each procedure, the urologic surgeon follows the same planning steps. Once satisfied with the individualized treatment plan, the robot will execute the precise Aquablation in approximately 5 minutes or less regardless of prostate size or shape. Patients’ concerns regarding an autonomous robot can be easily calmed, as the urologic surgeon monitors every aspect of the procedure and is able to instantly stop the procedure at any time by simply lifting his or her foot off the activation pedal."
After I posted last night, I got to thinking about the bleeding that you mentioned. I don't know or understand how the "bleeders" are sealed off in aquablation if heat is not used.
It would be great if we could read your post. I have a great deal of difficulty searching for posts on this site.
mikemh Motoman
Posted
Hi
Yes I had it done it the UK. At the moment there is really only one guy doing it, so I did pay for it. I believe however that it is going to be (or maybe now is) available free on our National Health Service.
Doc says it is essentially the same as TURP or Laser in terms of longevity; that means maybe up to 10 years.
Mike
russ_777 rdemyan
Posted
I read somewhere that at least in some cases of Aquablation the surgeon fires up a laser or plasma button electrode at the end to cauterize the bleeders. I'd think you'd have to.
derek76 russ_777
Posted
Sounds like a good idea.
Marty02 russ_777
Posted
Possibly. But, everyone bleeds pretty heavily for the first 24 to 48 hours after an aquablation. I would think such a need would be determined in the recovery unit after no reduction in bleeding is realized.
A lot of surgeries are done on the body sans cauterization. I'm not sure how much of an issue this really is.
russ_777 rdemyan
Posted
rdemyan -- On your question about dealing with bleeders post-Aquablation, I initially said below I thought I'd seen something about using something to cauterize.
I came across a study in which the efficacy and safety of WATER I (prostates 30-80 ml) WATER II (prostates 80-150 ml) in which Aquablation was used and the results compared between the two groups.
Here is what was said from a brief except from the paper:
Following the Aquablation treatment, the bladder was thoroughly irrigated to remove residual prostate tissue and blood clots. Haemostasis was achieved using tissue catheter tamponade with a low‐pressure Foley balloon catheter, which was inflated with 40–80 mL saline either at the bladder neck or within the prostatic fossa. The first 46 (40%) cases performed in W‐I used non‐resective cautery after Aquablation. The remaining 60% utilised balloon inflation in the prostatic fossa. In W‐II, bladder neck traction using a catheter tensioning device was used without any form of cautery.
So basically, at least in these cases, both electrocautery and blowing up a balloon inside the newly created cavity in the prostate were used. Interesting.Bottom line is you can't just let them bleed after a heat-free procedure, meaning there was no coagulation to close the vessels.
Truthmatters tom86211
Posted
NICE has produced a report that takes a look at Aquablation versus TURp. To avoid a link being blocked just search on* Interventional procedure overview of transurethral waterjet ablation for lower urinary tract symptoms caused by benign prostatic hyperplasia.
*
The report shows that by all measures Aquablation provides a significant improvement over and above that of TURP without running the significant risks TURP has been associated with.
Beginning to look like a front runner in the significant interventional options.
derek76 Truthmatters
Posted
I found several links dated September 2018 that were not that one. What date was your one ?
Publish he link it may get through as it is not a commercial link.
Marty02 tom86211
Posted
I recently started a discussion about this as I didnt see this discussion already existed. This forum has no search facility that I can find.
I would be interested to hear from anyone who is unhappy with their aquablation as I am only reading about success stories.
I am on the 12th day of my recovery. I stopped peeing blood on the 9th day. No more burning since the 6th day. No cath since the 2nd day. A strong stream since the 2nd day. I AM NORMAL AGAIN after decades with BPH. No RE (yet). I'm getting up no more than once a night. My aquablation is thus far a total success! Could this be a typical outcome?
If it is, I want everyone to know.
bob955 Marty02
Posted
Hi Marty,
I am getting different answers from different urologists. Was considering Rezum, now also Aquablation. I just turned 69.
As 2 years has passed, can you provide an update on your husband's Aquablation?
I also have a markedly distended bladder (same on 1999 report and successfully emptied for 14 yrs after a bladder diverticulectomy in 2000) and pelvic floor dysfunction supposedly from years of trying to compensate for my emptying issues.
Thanks
Bob
russ_777 tom86211
Posted
Slightly off topic but for those who've had it or found out, what (if any) insurance companies cover it and if you paid out of pocket, what was the cost? I checked recently and Aetna POS II still considers it experimental.
As far as RE goes, I would think that is highly dependent on the ablation map the surgeon programs during the planning stage. If he programs it to ablate a lot of apical tissue around the verumontanum then the robot is going to give you RE. It just ablates exactly what the surgeon programs it to ablate. If I were having Aquablation done, I might ask that I get to sign off on the ablation template once he programs it. Of course that might be hard to do if I'd already been induced. The fact that it generates little heat and doesn't send electrical current near nerve bundles helps.
Marty02 russ_777
Posted
Empire BCBS authorized mine after Procept worked on them. Theyre the mfr of Aquabeam. They have a dept that works the insurers to get this covered.
russ_777 Marty02
Posted
Marty, funny you should mention that. It's been several months but I had a long phone conversation with a lady in marketing/customer support at Procept and she mentioned that. She was very helpful. I want to say her name was Elizabeth.
Marty02 russ_777
Posted
Yes, i spoke to her also. Great lady. Too bad she spends her day talking us guys about prostates.
When you think about it, they have a compelling case to get insurers to pay for this "safer TURP." Good luck!