Aquablation for BPH

Posted , 38 users are following.

Very promising new treatment for BPH now in clinical trials (Water Study):

PROCEPT’s AquaBeam combines image guidance and robotics to deliver Aquablation, a waterjet ablation therapy that enables targeted, controlled, and heat-free removal of tissue for the treatment of lower urinary tract symptoms as a result of benign prostatic hyperplasia (BPH).

2 likes, 366 replies

366 Replies

Prev Next
  • Posted

    "For men with larger prostates (50-80 g), ........

    Postoperative anejaculation was also less common after aquablation compared with TURP in sexually active men with large prostates (2% vs 41%; P < 0.001) vs the overall results (10% vs 36%; P < 0.001). "

    2% Retrograde ejaculation, increditable! But not sure why.

     

    • Posted

      2% would be great If that was the way it is but you can not be sure.  Who are these doctors that are doing the Turp's Are they doing EP TURP.  Turp 41%  When you do a look up on Turp.  They tell you 97% you will have retro.  What are these doctors doing that the other doctor are not doinjg  Ken

    • Posted

      Hi Ken, 

      Ive been following the discussion and just wanted to confirm in my case anyway that there is a lot less ejeculate since I had the op 9 months ago.

      Grant.

       

    • Posted

      Hey Grant:  You had the Aquablation done.  Where did you have it done   How much would you say. A few drops.  Does it feel different.  Did you discuss it before hand with the doctor how much tissue to remove.  You did not that the only fluid your making is from what is left of the prostate.  Ken
    • Posted

      Hi yes I had it done here in the U.K. the surgeon assured me no retro which is true and at first a lot of sperm but very little now, it feels ok no different and yes I guess I’m getting it from what’s left of the prostate, my flow is still not good but I was very bad before he says a 50% improvement but I’m not sure about that! And no I did not discuss about how much tissue to remove.

      Grant.

    • Posted

      Plse see my latest post about WATER trial results.

      it was done double blind: the patients were assigned randomly either to TURP or Aqualation. In each arm, the patients were assigned randomly to the surgeons.

    • Posted

      Hi Grant- It's a shame that after 9 months your flow is not very good. Sorry to hear of that. 

      Thanks for sharing your experience... Cheers- J

    • Posted

      hello jay,

      i just read ur post on FLA in which u mentioned that u were waiting for aquablation to be offered. just curious did u have aquablation already?

    • Posted

      Hi d- Have not had any more surgeries... Flomax has helped quite a bit so I can continue to wait. I'm not convinced any longer that the Aqua is the way to go for me when the time comes. Originally my prostate size was 43cc, and I am sure that my prostate would be much smaller now post-FLA, although I have not had a follow-up MRI.  When I need another procedure I am leaning towards the TUIP, or incision of the prostate, which is supposed to work pretty well with smaller obstructive prostates, and the stats are much better than the Green Light. Cheers- J

    • Posted

      good reasoning; what u said makes sense!
    • Posted

      U may be interested in this paper:

      1557: Holmium Bladder Neck Incision (HOBNI) vs.Holmium Laser Enucleation of the Prostate (HOLEP) As Outpatient Clinic Procedures for Small Prostate Glands (<40g): A Randomised Trial With One Year Follow-Up

      The Journal of Urology, 

      Volume 171, Issue 4, Supplement, 

      April 2004, 

      Pages 410-411

      Peter J. Gilling, 

      Katie Kennett, 

      Tevita Aho, 

      Andre Westenberg, 

      Mark Fraundorfer

    • Posted

      Glad you are doing ok. I got this when I was asking about the volume that would be left. I got this from one of the doctor that was working on Aquablation.        I'm afraid that the planning is in real time.         When you are asleep.      You can't identify the prostatic or the common ejaculatory ducts.  I'm afraid.  But you could plan to be conservative at the bladder neck where the ducts emerge in hope of a higher rates.But that is as far as it goes.  If you want a procedure that has 100% preserves all sexual function. Then the Urolift is the only option with good data behind it.  I have a problem with them doing the mapping while you are asleep.  I want to see what you are doing Not getting a surprise.  Ken   

    • Posted

      Urolift vs bladder neck incision: I agree with Ken. Urolif wins as it does not remove any tissue and it guarantees no RE
    • Posted

      Hello Ken,

      I am confused. do u have time to elaborate? For Aqua, I do understand that it is real time planning. While the patient is under anaesthesia, the TRUS is inserted followed by the Waterjet hand piece. Then the mapping is carried out. 

      I also agree that the TRUS image is kind of blur and many times less clear than the image from cystoscopy. So avoiding anatomical landmarks has to be done with more margin.

      Below statements were  what the aquablation Doctor said, yes?

      "You can't identify the prostatic or the common ejaculatory ducts.  I'm afraid.  But you could plan to be conservative at the bladder neck where the ducts emerge in hope of a higher rates."

      --- I thought the ejaculation ducts sit on the top of the verumontanum not the bladder neck???

      2) "But you could plan to be conservative at the bladder neck where the ducts emerge in hope of a higher rates.But that is as far as it goes.  If you want a procedure that has 100% preserves all sexual function."

      ---- did he meant that he deliberately left a lot of tissues at the  bladder neck uncut, which otherwise should have been cut  ? 

      The other thing I am confused is that I thought the internal sphincter is located at the bladder neck. Injuring the internal sphincter causes stress incontinence. In that regard, leaving more tissue at the bladder neck uncut  will lessen the chance of injuring the internal sphincter. This is a good thing. But the downside is that the blockage still exists at the bladder neck,

    • Posted

      Hello DL   I wrote it just the way he sent it to me.  He is talking about the connection of the seminal canal were it meet the ejaculation ducts in the center of the veru.  I guess it is by the opening of the bladder neck.  I don't think that would help.  I do not think they very at all Just get rid of everything in the center to make the tunnel. So your volume is not that much.  I got it from Mr. Barber I guess they are trying but they need to try harder..Ken  I don't know if 15% of 100% is worth all the trouble   

    • Posted

      I asked him if then can do like the right side of the prostate and half of the left side so you would not touch the seminal canal so your ejaculation would only change by 15 %.  He said no that they have to do it that way.  So the concerns of the patient are not listen to. Ken
    • Posted

      Hey Grant.  How are you doing.  I hope you get some more improvement maybe in time but who knows.  God bless you and hold you in his heart  Ken
    • Posted

      Hi ken, I’m ok but of course disappointed that it was not a better outcome, Mr Barbour did mine  he is a very nice guy and I expect I will have to go back to him in the future. For the time being I will put up with a still weak stream but at least now I am not retaining urine.

      Grant.

    • Posted

      I wish it was a better outcome.  I think that was the guy I got some of my questions answered.  Being you are asleep before they do the mapping I took it that they do not talk to the patient before they do the mapping.  Did they talk to you or ask your concerns Grant.  I still think that is not right.  And they can't very for the making the tunnel  Ken 

    • Posted

      Hi Grant, a weak stream with little retention is way better than a strong stream with high retention. Hank

Report or request deletion

Thanks for your help!

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.