Understanding benign prostatic hyperplasia (BPH) and aquablation

As men age, it's common to experience changes in their health, one of which is benign prostatic hyperplasia (BPH), also known as prostate enlargement. This condition affects most men at some point in life, particularly those over the age of 50.

BPH occurs when the prostate gland, which is located just below the bladder and surrounds the urethra, enlarges and begins to press against the urethra. This compression can lead to a variety of uncomfortable and disruptive symptoms.

Symptoms of BPH

BPH can significantly impact a man's quality of life. Common symptoms include:

• Frequent urination: Especially during the night (nocturia), causing disrupted sleep.
• Urgency to urinate: A sudden and strong urge to urinate, often difficult to control.
• Weak urine stream: Difficulty in starting urination or a weak or interrupted stream.
• Incomplete bladder emptying: Feeling that the bladder is not fully empty, even after urinating.

These symptoms can range from mild to severe and can cause significant distress, leading many men to seek treatment. Importantly, there are many possible underlying causes of these urinary symptoms, and so it is important to see a urologist who specialises in the full range of treatments for prostate and bladder diseases.

Choosing a specialist

Mr Sachin Malde is one of the few specialists in the UK offering the entire range of treatment options for BPH, as well as bladder diseases that may also cause urinary symptoms. He is an expert in investigating the underlying cause of urinary symptoms in men and targeting the treatment best to the individual patient.

He has considerable experience in all minimally-invasive and surgical treatments for prostate enlargement; through his role as a board member on the European Association of Urology prostate enlargement panel, he is involved in lecturing and training other urologists on these novel techniques.

Treatment options for BPH

Once it has been confirmed, through detailed investigation, that prostate enlargement is the causes of a patient’s symptoms, the treatment options can then be discussed. Several treatment options are available for BPH, depending on the severity of symptoms and the patient’s overall health. It is important to see a urologist that specialises in all these potential options, so that a patient can chose the option that fits best with their individual preferences and lifestyle. The options include:

1. Medications: Such as alpha-blockers and 5-alpha reductase inhibitors, which can help relax the prostate muscles or shrink the prostate over time.
2. Minimally invasive procedures: Techniques like Rezum, Urolift, iTind, Optilume BPH, all use different energy modalities to relieve obstruction from the enlarged prostate. Each has different risks and benefits, and so patients should see a urologist who is experienced in all the options available to enable a detailed discussion on these treatments.
3. Surgical procedures: In more severe cases, surgery may be necessary to remove or reduce the prostate tissue causing the blockage. Traditionally, this is done with transurethral resection of the prostate (TURP) or laser enucleation surgery.

The limitations of traditional TURP surgery

One of the most common surgical treatments for BPH is Transurethral Resection of the Prostate (TURP). This procedure involves the removal of prostate tissue using a resectoscope inserted through the urethra. While TURP is effective in relieving urinary symptoms, it has a significant drawback: the potential for sexual side effects.

One of the most concerning side effects of TURP for many men is retrograde ejaculation. This occurs when semen enters the bladder instead of exiting through the urethra during orgasm, leading to "dry orgasms." While not harmful, this can impact sexual satisfaction and is a major concern for men considering prostate surgery.

Introducing Aquablation: A precise and less invasive option

Aquablation is an innovative surgical procedure that offers a promising alternative to traditional methods like TURP, especially for those concerned about sexual side effects. This minimally invasive treatment uses a high-pressure water jet controlled by robotic technology to remove excess prostate tissue. The precision of Aquablation minimises the risk of damage to surrounding tissues, particularly those involved in sexual function.

Key advantages of Aquablation

1. Reduced risk of sexual side effects: Unlike TURP, which carries a higher risk of retrograde ejaculation, Aquablation significantly reduces this risk. By precisely targeting only the overgrown prostate tissue and preserving surrounding areas, Aquablation helps maintain normal sexual function, allowing men to enjoy life without the worry of losing ejaculatory function.
2. Minimally invasive: Aquablation is performed using a transurethral approach, meaning there are no external incisions. This results in quicker recovery times, less pain, and fewer complications compared to traditional open surgery.
3. Robotic precision: The combination of advanced imaging and robotic technology ensures that the procedure is tailored to the unique anatomy of each patient. This precision enhances the effectiveness of the treatment while minimizing the risk of complications.
4. Effective symptom relief: Studies have shown that Aquablation provides lasting relief from the urinary symptoms of BPH, comparable to that of TURP, but with fewer side effects.

Is Aquablation right for you?

If you’re experiencing symptoms of BPH and are concerned about the impact of traditional surgery on your sexual health, Aquablation may be the right choice for you. It's particularly beneficial for men who want to maintain their quality of life without compromising on the effectiveness of their treatment.

Discussing your symptoms and treatment goals with a urologist who specialises in this technology is the first step toward finding the right solution. Aquablation represents a cutting-edge option that combines the best of modern technology with a focus on preserving sexual function, offering hope to men looking for a better way to manage BPH.

By choosing Aquablation, you can address your prostate health concerns confidently, knowing that you’re making a choice that prioritizes both your physical and sexual well-being.