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
dl0808 tom86211
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"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.
kenneth1955 dl0808
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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
grant75607 kenneth1955
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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.
kenneth1955 grant75607
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grant75607 kenneth1955
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Grant.
dl0808 kenneth1955
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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.
kenneth1955 grant75607
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jay111 grant75607
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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
dl0808 jay111
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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?
jay111 dl0808
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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
dl0808 jay111
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dl0808 jay111
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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
kenneth1955 jay111
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
dl0808 kenneth1955
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dl0808 kenneth1955
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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,
kenneth1955 dl0808
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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
kenneth1955 dl0808
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kenneth1955 grant75607
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grant75607 kenneth1955
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Grant.
kenneth1955 grant75607
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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
hank1953 grant75607
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