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  • Writer's pictureSandeep Bagla

What is an Aquablation?

Aquablation uses a guided robot and imaging to increase urinary flow, and alleviate urinary symptoms. It has surgical outcomes comparable to older methods such as the “roto rooter” or the TURP often with no sexual side effects. Aquablation is done after the patient goes through preoperative work-up, and the physician determines that they are an appropriate candidate for the procedure. They are taken to the operating room, and are given a general anesthetic or spinal anesthetic with sedation. The patient is positioned, and then an ultrasound imager is used to make a map of the prostate that gives dimensions, and to look at the parts of the prostate.

After that map is made to determine what parts of the prostate we want to treat, and what parts we want to preserve in order to minimize the side effects, we put a telescope through the urethra. On the ultrasound map that we make, we locate the robot and telescope in the bladder. This orients the robot where it is in the prostate map. After that the robot knows where it is located. The robot knows based on the map what parts of the prostate need to be treated, what parts need to be spared, what parts need to be left in place to avoid sexual and urinary side effects. After the robot is oriented, it uses the map to treat the desired parts of the prostate. It uses a cold water jet to carve out that part of the prostate we want to remove while avoiding the parts of the prostate we want to leave in place. While avoiding excess pressure, and avoiding removing parts of the prostate that need to stay in place. The robot controls how much pressurized water goes through to remove a certain amount of tissue but leaves the rest in place.

After that removal is done, the patient has had a procedure similar in efficacy and durability to the old school transurethral resection of the prostate (TURP). It is durable, lasts for a long time, and has surgical results with the removal of tissue, but with a much lower rate of dry orgasm and sexual side effects than the TURP. The Aquablation replicates the durability and efficacy of the TURP, without causing erectile dysfunction and without causing other sexual side effects.

Aquablation has been FDA cleared for some years. Our physicians are national leaders in Aquablation performing high volumes of this procedure annually.

Most patients with Aquablation stay one night of recovery in the hospital. Then after that the catheter gets removed the next morning and they go home. For a few weeks there is mild irritation after the procedure, and they may go to the restroom more frequently than before, but then quickly recover.

Most patients can resume normal activities somewhere between 1-3 weeks. Once blood is gone for 3-4 days from the urine, you can resume normal activities. For most patients this ends up being in the neighborhood of about 2-3 weeks. If patients return to normal activities too early, they are not at risk for hernias or other complications like after open or laparoscopic surgery. But the risk is that blood will return to the urine, and they may have more bleeding after the procedure. We recommend that patients take it easy for 1-3 weeks.

There are only two procedures that can be performed on patients that are still on blood thinners which cannot be stopped or can only be stopped for a very brief time. One is the PAE, the other is the HoLEP procedure. Both procedures can be performed on patients who are on a blood thinner or anticoagulant, that cannot stop or can only stop for a very short period of time. Whereas with most other procedures patients will need to stop blood thinners for up to a week or two.

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