Let’s Talk Health: Aquablation- The Most Advanced Treatment for Enlarged Prostate

An enlarged prostate or Benign Prostatic Hyperplasia (BPH) is a common health issue for men, particularly as they get older. According to Dr. Saman Moazami, Urologist at Saint Clare’s Health, men suffer from the many uncomfortable and disruptive symptoms, and often delay seeking professional solutions from a urologist. At Saint Clare’s Health, a new and advanced treatment for enlarged prostate known as Aquablation, provides an effective method to treat BPH while minimizing risk and worry.    

The road to Aquablation begins with identifying the symptoms of an enlarged prostate. Dr. Moazami notes that some of the most common symptoms are a weak urine stream, increased daytime frequency and urgency to urinate, waking up multiple times at night, and the sensation of incomplete bladder emptying. This can ultimately lead to increased stress on the bladder. 

“Increased pressure on the bladder, results in men having a sensation of urgency and frequency, feeling as though they need to frequently urinate,” Dr. Moazami explained. This can be quite disruptive to a lifestyle. For example, men may need to locate the nearest restroom, stop frequently on road trips, or leave work meetings. “Patients can also have urinary incontinence or leakage associated with enlarged prostate. In the most severe cases, they can't urinate at all, which can be life threatening.” 

Dr. Moazami pointed out an initial approach in treating this condition, is the introduction of behavioral modifications. For example, reducing the intake of caffeine and alcohol, particularly in the evening is helpful.  There can be other bladder irritants, too, such as spicy and acidic foods. Patients are also counseled on limiting food and fluid intake to three or four hours prior to bedtime. “Overall, we work together with patients to determine the best treatment course in order to achieve relief of their symptoms.” 

If behavioral modification is not sufficient, then alternative options are considered. An enlarged prostate is essentially a blockage of the lower urinary tract that can regularly be addressed with medication. The often-prescribed medication Flomax (Tamsulosin) works by relaxing the muscles in the prostate and bladder neck. However, there can be complications such as abnormal ejaculation, dizziness, and orthostatic hypotension. This is when a person's blood pressure drops precipitously when standing up too quickly. While the majority of men tolerate medications with minimal to no side effects, many will require further treatment in the form of a surgical intervention.

This is where Aquablation comes in. Aquablation therapy is a robotic assisted procedure that removes prostate tissue using the power of water. The treatment, which can be used on any size prostate, is performed in a hospital under anesthesia. The procedure typically takes less than an hour, and may involve an overnight stay. 

Before the recent advent of Aquablation, the most common type of surgery was the transurethral resection of the prostate (TURP) procedure. A TURP removes the obstructive prostate tissue by using a heat-based system, such as laser or cautery, to resect the tissue, and is limited to specific prostate size. 

Aquablation has more than one important difference from TURP. First, it is the only procedure that combines a camera (called a cystoscope) with ultrasound imaging, giving the surgeon the ability to see the entire prostate in real time. The addition of ultrasound imaging in Aquablation therapy, allows the surgeon to map the desired area of tissue removal.

With the precise treatment plan in place, a robotically controlled, heat-free waterjet removes the prostate tissue that has been mapped out. This robotic technology minimizes human error in removing critical prostate tissue, and ensures the prostate tissue is removed precisely, consistently, and predictably. This precision allows the surgeon to map around the parts of the prostate that cause irreversible complications, such as ejaculatory dysfunction and incontinence.

Dr. Saman Moazami - Urologist, Saint Clare's Health

 Dr. Moazami emphasizes that this advancement in medical technology can make a significant difference in the post-treatment life of his patients. 

“There is a misconception thinking the robots are going to come in and do the job. It’s actually a physician-led robotic assistant that allows for positive outcomes,” Dr. Moazami said. “When it comes to sexual issues arising from BPH treatments, it’s an important part of the decision making process for patients. Aquablation lets patients worry less about what comes after prostate surgery, and to focus more on improving their urinary symptoms.” 

Dr. Moazami knows men may be worried about prostate issues as they age. For men in their 60s, it has been reported that up to 70 percent will have some sort of issue with their prostate. As men age, this number continues to rise. However, Dr. Moazami assures his patients that the care they receive at Saint Clare’s Health is exceptional. “Men can be confident that they will receive treatment with the most advanced technology, close to home. The best in class care you receive at Saint Clare’s Health from clinically advanced physicians is what I would want for my family and myself. On all levels, Saint Clare’s Health delivers high quality care.”

For more information on Aquablation, please visit https://www.saintclares.com/services/surgical-services/aquablation/