New prostate BPH procedure called Aquablation

Posted , 22 users are following.

There is a new surgical procedure for BPH called Aquablation - FDA approved in the USA this year. I had it done ten days ago. After decades of suffering, I am already feeling the benefits of a normal happy bladder. I can finally empty, have a strong stream and go for three to six hours between feeling any need to urinate. Still a trickle of blood comes out once in a while, so I am still healing. Its only been ten days!

Aquablation uses high velocity saline water jets to remove prostate tissue with the "Aquabeam" robot. No heat, vapor, laser, hardware left in prostate, etc. Same outcome as TURP without sexual side effects or long recovery.

My advice to BPH sufferers seeking an effective procedure: no large median lobe, consider doing PAE (I had mine done several years ago, but my large median lobe remained a problem); otherwise, consider doing an Aquablation. Google it!

Anyone else out there who has had an Aquablation?

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  • Posted

    Clarification to my post: Aquablation promises the same outcome as TURP with far less incidence of sexual side effects when compared to TURP, it does not - to my knowledge - fully eliminate the possibility. Ask your doctor about this. (Why is there no way to edit your own post here?)

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    • Posted

      Not sure what is meant by urinary retention. Several ultrasounds pre-surgery revealed my bladder post void still had 400ml left in it.

      If there is such an exclusion, it must refer to total inability to urinate. I'll try to remember to ask my doctor what that exclusion is about.

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    • Posted

      yes, it is what i meant.

      here are the exclusion criteria

      • Active infection

      • Urinary retention

      • Postvoid residual volume > 400 ml

      • Abnormal renal function

      • Raised prostate-specific antigen level

      • Current/suspected bladder/prostate cancer

      • Neurogenic bladder/sphincter abnormalities

      • Previous prostate surgery

      • High anaesthetic risk

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    • Posted

      One possible reason for this urinary retention exclusion criteria: A functioning bladder was very important just to flush out my urinary tract post op and avoid infection.

      There are probably other reasons.

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  • Posted

    so this does NOT work for median lobe?

    and like Rezum they go puncture through the urethra to deliver the blast to the prostrate?

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    • Posted

      Aquablation, like TURP, can be used for the median lobe. That is why I had it done.

      Yes, it is a through the urethra procedure. Because, it uses unheated saline under the guidance of a robot, it promises the least amount of collateral damage when compared to TURP and quickest recovery.

      Rezum uses steam, relies more on surgeon skill, and seems to have a longer recovery, from what I've read.

      Y'know, you get to the point where you just have to decide if you are miserable enough to do any of these procedures. I got to that point and, in my opinion, PAE and Aquabeam were my two best options! The former failed to fix my median lobe, the latter seems to have done the job.

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  • Posted

    I had the REZUM 4 months ago. I have some relief but not complete.

    My Uro is concerned enough to order more testing -- Urodynamics and another cytoscopy.

    I was recommended for the Aqua but my insurance wouldn't cover it. I appealed and haven't heard anything. So instead I did the REZUM as the "less invasive" procedure. My recovery from it was very long. CIC for a solid month.

    Re Aqua:

    How long was the recovery?

    What was the recovery like?

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    • Posted

      I stayed overnight in hospital with catheter. They flushed the blood and debris all night long through the catheter. I was never in agony, but I was certainly not happy having the catheter.

      As the fluid became less bloody, the doctor felt comfortable removing the catheter before discharge.

      Tentatively, I made my first urination and it was bloody, burned a lot, but - wow! - check out that race horse urine stream!

      Upon discharge I feared the ride home, but was pleasantly surprised that my pre-surgery issue of constant feeling of a full bladder was gone.

      At home, drank 3 to 5 liters per day to help the flushing process. I never would dare drink that much before the procedure, but now voiding was easy, especially as burning subsided. 48 hours after the procedure I was very comfortable (no substantial burning) and, now 10 days post op, there is no burning with only an occasional trickle of blood.

      I am urinating every 3 to 6 hours, 400ml to 600ml, quickly and easily. I have not had sex yet, as I want to let the prostate heal for a few weeks.

      Your one month CIC after Rezum sounds atypical. I cant say if such atypical events wont also happen with Aquablation.

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  • Posted

    Hi Marty,

    It has been discussed a fair amount here and a few guys here on the forum who have had it and are very happy with it. The leader of the clinical trials in this country is Dr. Desai at the University of Southern California. A fellow here on the forum put me onto him and I went up and saw him and had a full workup (Prostate MRI, urodynamics, and cystoscopy) there. I was very impressed by him and USC but ultimately Dr. Desai thought that my bleeding risk was a little too high (I have low platelets from lymphoma chemo treatments many years ago) for an Aquablation procedure and recommended a TURP. My doctor down here at University California - Irvine agreed with Desai and I will have a TURP sometime in the coming 6 months hopefully (some other non prostate medical issues currently going on). My doctor at UCI participated in the clinical trials as the VA in Long Beach as well.

    I think that once insurance companies start to cover it it will be more mainstream but right now I think that the price tag out of pocket is extremely expensive (before any subsidy from the manufacturer as you mentioned).

    Best of luck!

    Rob

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    • Posted

      Best of luck to you as well. I am not aware of Procept (mfr) subsidizing private pay, although they might. They have a reimbursement team that helps doctors get this procedure approved by each patient's insurer. I am told they are often successful as this is a FDA approved procedure with a CPT billing code and favorable outcomes data.

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    • Posted

      Rob,

      I commend you on your research. You have no doubt found the best advice and procedure for you. This process of selecting the best procedure takes work. Thanks for the info.

      Marty

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    • Posted

      Hi Marty,

      You are correct about Procept not subsidizing private pay. I misstated that (I wish that we could edit posts here!) What I meant to say, as you did, is that Procept is assisting people in getting insurance companies to cover it. It takes a while for insurance companies (including Medicare) to be convinced of medical viability. This is pretty normal for newer procedures (for any medical condition). Typically, once Medicare starts to cover a procedure then the other insurance companies do as well, they are kind of the gold standard.

      Rob

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    • Posted

      TURP is almost never a good first option. Aquablation's biggest weakness is the amount of long term bleeding associated with it so your doc was right that you're not a good candidate. But there is less bleeding and shorter recovery with Rezum than TURP and typically the results are as good

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