What is the Aquablation Procedure?

June 19, 2023
When a man is young, Prostate tissue growth is desirable because it naturally leads to sexual maturity. However, when prostate enlargement continues later in life, and a BPH diagnosis based on lower urinary tract symptoms or LUTS is determined, it can lead to health and lifestyle difficulties. Benign prostatic hyperplasia, or BPH, is benign and thus not prostate cancer, but when accompanied by LUTS, it can still be a life-changing problem. A low percentage of fortunate men will never experience an enlarged prostate. And a slightly enlarged prostate may cause no symptoms or issues for some men. For others, mild BPH symptoms may only slightly alter a man’s lifestyle. Yet many men will eventually have to deal with moderate to severe LUTS brought on by BPH and they will search extensively for the best symptom relief possible. Unfortunately, if prostate tissue growth is severe enough and left untreated for too long, irreversible complications such as bladder or kidney damage can occur. Fortunately, Aquablation therapy can help. The answer to the question: “What is the Aquablation Procedure?”, is both innovative and revolutionary. First introduced in 2013, Aquablation is a completely different, highly advanced, patented and FDA Cleared minimally invasive resective procedure that addresses lower urinary tract symptoms or LUTS brought on by BPH, and utilizes the Aquabeam robotic system designed and manufactured by Procept BioRobotics. It can be truly transformative for both men and their prostate health. Essentially, Aquablation therapy is a non-compromising, life-altering BPH treatment that can completely change a man’s outlook for the better. Utilizing the precision of robotics, while harnessing the power of water, Aquablation uses high-pressure saline to remove excess prostate tissue present in BPH patients to relieve the pressure that the prostate has placed on the urethra and possibly the bladder. Aquablation is a one-of-a-kind procedure that has demonstrated low rates of irreversible complications, such as urinary incontinence, erectile dysfunction, and ejaculatory dysfunction, compared to published rates observed for other resective surgeries.1,2

Life with BPH

In a survey, 99.7% of men say BPH impacts their quality of life.6 When watchful waiting (actively monitoring BPH symptoms without treatment) has run its course, or BPH medication is no longer effective or desired, surgery may end up being the most effective long-term solution. It could also be the most cost-effective depending on the type of lifestyle adaptations needed to address BPH symptoms or medication being taken for LUTS. Of course, the right therapy for each individual’s health and lifestyle goals is crucial. Some men may simply want relief from having to get up to use the bathroom every hour or two during the night. Other men may want to make sure they never experience urinary retention again or that they avoid getting recurrent urinary infections. Yet other men may want to have their cake and eat it too by eliminating all of their BPH symptoms while at the same time having a great chance of retaining all of their sexual and urinary functionality. 92% of men who are considering BPH surgery in the next year say maintaining erectile function after surgery is important.6 And 91% of men who are considering surgery in the next year say maintaining ejaculatory function after surgery is important.6 Not to be left out, 85% of men who are considering surgery are concerned with incontinence as a side effect.6 Each man is different in their needs and desires. However, it appears that most men agree that if their doctor were to ask them if maintaining their current level of sexual functionality is important to them when considering a BPH treatment, they would answer Yes. Additionally, a survey showed that 83% of men with BPH are not willing to sacrifice sexual function for symptom relief with surgery.6 Luckily, Aquablation therapy can grant these wishes for the vast majority of men.

Aquablation Therapy

Fortunately, science and technology have caught up with BPH and its myriad of bothersome lower urinary tract symptoms. Aquablation therapy is a minimally invasive, heat-free, safe, and effective BPH treatment that can handle any size or shaped prostate. Aquablation is custom-tailored for each man based on his unique anatomy. It can address all of the BPH symptoms that men experience while retaining the current range of sexual functionality for nearly every man. Trial studies show that 100% of sexually active men with BPH who underwent Aquablation therapy maintained erectile function.3,4,5 And 99% of men with BPH did not develop incontinence after Aquablation therapy.3,4,5 In addition, nearly all men with BPH preserved ejaculatory function after undergoing Aquablation therapy.3,4,5 Aquablation is a different type of BPH treatment because it is the only therapy that utilizes a heat-free robotically controlled waterjet to quickly and precisely remove excess obstructive prostate tissue via the urethra without any incisions and does not damage vital anatomy controlling critical sexual and urinary function. Aquablation therapy is also the only BPH procedure that gives a surgeon the ability to view the entire prostate in real time through the use of both a camera-aided cystoscope and ultrasound imaging. This greatly aids in decision-making and real-time monitoring during the procedure. It also gives a multidimensional view of the prostate which greatly assists in the proper placement of the Aquablation resective waterjet that is attached to the Procept BioRobotics Aquabeam robotically controlled system. With the use of surgeon-controlled imaging software, the prostate is digitally mapped so excess prostate tissue can be safely removed while preserving portions of the prostate that, if damaged, could result in irreversible complications such as erectile and ejaculatory dysfunction and incontinence. The surgeon-supervised, but robotically-controlled heat-free Aquablation waterjet rapidly resects the mapped-out problematic prostate tissue while leaving alone delicate anatomy that controls erectile and ejaculatory function and continence. The resected tissue is then removed. The resection time is consistent across all prostate shapes, sizes, and a surgeon’s experience level.

Benefits of Aquablation

Although there are numerous benefits, here are 15 key advantages of Aquablation therapy.
  • Performed on any size or shaped prostate from 30 to over 200 grams
  • Digital mapping of the prostate before the resective phase
  • Multidimensional view of the prostate via camera and ultrasound
  • Robotic precision
  • Heat free resection
  • Incision free
  • Sphincter Preservation
  • Waterjet removal of obstructive prostate tissue
  • Substantial debulking of prostate tissue
  • Safe & Effective
  • Symptom relief in days
  • Minimal side effects
  • Long-lasting relief
  • 10/10 men preserve continence7
  • 10/10 men preserve erectile function and 9/10 men preserve ejaculatory function7
Aquablation therapy is a one-of-a-kind, highly effective, safe, long-lasting, robotically controlled resective procedure that utilizes a heat-free saline waterjet to remove problematic prostate tissue of any size or shape, thus eliminating LUTS brought on by benign prostatic hyperplasia in men. With Aquablation therapy, men no longer have to choose between safety and efficacy. Aquablation eliminates the compromises that have to be made with many alternative surgical BPH procedures that address an enlarged prostate. With Aquablation, men can now get BPH relief without unwanted irreversible complications. Aquablation is simply a better treatment option for both patients and urologists.   References
  1. https://www.canjurol.com/html/free-articles/Cdn_JU27_I1_05_FREE_DrGilling.pdf
  2. Leong JY, Patel AS, Ramasamy R. Minimizing Sexual Dysfunction in BPH Surgery. Curr Sex Health Rep. 2019 Sep;11(3):190-200. doi: 10.1007/s11930-019-00210-1. Epub 2019 Jul 20. PMID: 31467497; PMCID: PMC6714584.
  3. Gilling PJ et al. Five-year outcomes for Aquablation therapy compared to TURP: results from a double-blind, randomized trial in men with LUTS due to BPH. Can J Urol. 2022 Feb;29(1):10960-10968.
  4. Bhojani, N, et al. Aquablation for Benign Prostatic Hyperplasia in Large Prostates (80-150 cc): 1-Year Results. Urology. 2019 Jul;129:1-7.
  5. Data on file at PROCEPT BioRobotics.
  6. Survey data on file at PROCEPT BioRobotics, A Guidepoint Market Research, Patient Survey
  7. Elterman D. et al. Meta-analysis with individual data of functional outcomes following Aquablation for lower urinary tract symptoms due to BPH in various prostate anatomies. BMJ Surg Interv Health Technologies. 2021 Jun

All surgical treatments have inherent and associated side effects. Individual’s outcomes may depend on a number of factors, including but not limited to patient characteristics, disease characteristics and/or surgeon experience. The most common side effects are mild and transient and may include mild pain or difficulty when urinating, discomfort in the pelvis, blood in the urine, inability to empty the bladder or a frequent and/or urgent need to urinate, and bladder or urinary tract infection. Other risks include ejaculatory dysfunction and a low risk of injury to the urethra or rectum where the devices gain access to the body for treatment. Further, there may be other risks as in other urological surgery, such as anesthesia risk or the risk of infection, including the potential transmission of blood borne pathogens. For more information about potential side effects and risks associated with Aquablation therapy for Benign Prostatic Hyperplasia (BPH) treatment, speak with your urologist or surgeon. Prior to using our products, please review the Instructions for Use, Operator’s Manual or User Manual, as applicable, and any accompanying documentation for a complete listing of indications, contraindications, warnings, precautions and potential adverse events. No claim is made that the AquaBeam Robotic System will cure any medical condition, or entirely eliminate the diseased entity. Repeated treatment or alternative therapies may sometimes be required.

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