Cutting through with Aquablation

Aquablation is a minimally invasive surgical procedure that uses high-pressure water jets to resect any excess tissue of the prostate. It is a new technology that is changing how men can get treatment for benign prostate enlargement (BPE). In this article, consultant urologist Mr Michael Wanis explains this technique in further detail.

What is Aquablation?

Aquablation is a state-of-the-art technique designed to address the symptoms and growth of BPE. It uses water jet technology, real-time ultrasound, and robotic assistance to excise protruding prostate tissue while still preserving the surrounding tissue and organs without disrupting bladder and sexual function. Each procedure is tailored to every patient’s anatomy and requires no incisions to perform.

Who can undergo this procedure?

Aquablation is recommended for men who have a larger prostate, as those with a minimal expansion of the prostate might not be suitable for the procedure.

BPE is a condition that typically affects men over the age of 70 years old. It is when the prostate, a gland that sits below the bladder in the male anatomy, increases in size. The prostate is normally the size of a walnut, but it can grow to three times that size, obstructing the urinary tract and affecting sexual function. Symptoms of BPE include incontinence, a higher frequency of the urge to urinate (both in the daytime and nighttime), difficulties when trying to urinate and maintaining a consistent stream, and blood in the urine. In advanced BPE, men can struggle with erectile dysfunction and ejaculation.

What happens during Aquablation?

The surgery takes around 60 to 90 minutes, and is performed under a general anaesthetic. An ultrasound and a cystoscope, which is a small telescopic camera inserted through the urethra, are used to create a surgical map, providing surgeons with 3D imaging of the internal structures. With this information, they are able to plan the procedure with the robot, enabling them to be precise and efficient. Then, the heat-free water jet is utilised to remove the prostate tissue.

Patients usually stay in the hospital for one or two nights for recovery and monitoring; they will be fitted with a catheter to facilitate urination for a day or so. For some patients, Aquablation can be a day-case.

What are the side effects and aftercare of Aquablation?

Aquablation has fewer side effects than other methods for addressing enlarged prostates (such as transurethral resection of the prostate), with consistent results, shorter recovery time, higher precision, and rapid relief of the symptoms for patients. Sexual function and continence are restored, and patients can return to daily activities soon after the surgery.

As with any surgery, there are risks such as a bad reaction to anaesthetic or internal bleeding, but these risks are very low with Aquablation. As of now, there is not much data on any long-term side effects because of how new this technique is, with only around five years of data available.

If you would like to know more about Aquablation and other methods of treating BPE, consult with Mr Wanis today via his Top Doctors profile.