Has anyone heard of the Aquablation procedure for BPH? It looks like a newer treatment with using water (but not like Rezum) and robotics to do the procedure. One of the comments mentioned is being able to treat larger prostrates; 80 to 100
It's only available from Neil Barber in London. New. Jetwash inside your prostate. Instead of laser. "The AquaBeam system is a first of its kind, image-guided system delivering a treatment utilizing water and robotics for the targeted removal of prostate tissue. AquaBeam combines image guidance and robotics to deliver Aquablation, a personalized waterjet tissue resection modality. Under real-time image-based ultrasonic guidance, AquaBeam enables surgical planning and mapping, and allows for a controlled resection of the prostate with a high-velocity saline stream".
He claims to avoid retro 93% of the time. Presumably then, this doesn't work (is not used) on top of prostate. That'll presumably mean that frequency issues may not be as well addressed, as they arise from growth on top. But would presumably address flow rate issue. I wonder how he prevents the jetwash tunnelling too far out of the prostate; how does he limit jetwash range ? He seems to be sole source of info.
there were a lot of discussions in this forum and a great deal of data from clinical trials . please do a search.
I believe that even laser surgeons can avoid retro IF they avoid work on TOP of prostate. e.g. my HOLEP surgeon Marc Laniado now offers ejac-preserving HOLEP (not offered in July 2016 when I had mine). I am sure this comes at the price of, if your prostate was bulging up on bladder base, less amelioration of frequency issue. The jetwash thing sounds like a variant of laser really. I presume the device goes in same way. I wonder if the jetwashed tissue is granular enough to be tested for cancer like Holep chunks, or too mashed up to do that histology. I wonder if swelling is same as with laser, I wonder if it can anneal blood vessels as well or, I expect, you might get more bleeding with jetwash as no heat to anneal ?? How does Neil Barber prevent bleeding ? Is it as painful to pee after .... I guess yes, you're still peeing thro a great big open wound, the inside of the prostate. Is it done under general ? Interesting, so many questions. Men who had it, please post !!!
on top of prostate, do u meant medium lobe protruding into the bladder?
Barber is one of the author in a aqua clinical trial. i would believe what he said. indeed, 93% retro is one of the major advantage of aqua.
I see that I should more carefully word my question. Has anyone in this forum actually had the Aquablation procedure. There are clinics in the USA who are doing them now, two of which are in Southern California. (there are no clinics in my area unfortunately) I'm currently scheduled for a Button Plasma TURP and wondering if the Aquablation would be worth pursuit. My prostate was measure at 90-100 and TURP was the procedure offered by the doctor. The doctor said my prostate was too large for Rezum. Age 60. I've had typical symptoms of BPH for a few years then last month hit with sudden urinary retention. Now doing intermittent CIC along with Flomax twice a day.
What are the names and locations of the two clinics in Southern California? Are there any in Northern California? Does insurance and/or Medicare cover it?
There is one in Northern Cal. El Camino Urology Medical Group. Karpman and Lai are the doctors. The one in SoCal is the Keck Hospital at USC. I'm not sure if private insurance or Medicare cover it. In my case, I am still under my deductible so it is all out of pocket.
no need to be careful whatever comes to ur mind, we are no doctor here.
if u could wait, i would suggest u hold off doing bp turp temporarily until u have a chance to understand the consequence and if there are better option to meet ur objective. it could take u a month or more.
as regard to aqua, the answer is yes. also i had post a huge amount of data from several clinical trials. except i don't remember where in this forum.
Lance, you have the luxury of CIC and flomax. There's no reason to rush into any procedures. The last time I was offered TURP, I changed urologist. Hank
I would recommend against Button TURP and Aquablation. The latter is essntially performing TURP but with water instead of a knife. Both have long recoveries and both are probably overkill for what you need.
Plenty of doctors do Rezum on prostates as large as yours and for the most part, it works well, although generally, the big ones take longer for the full effect.
While most people end up OK with Button TURP, its a surgery, with anesthesia, all of the attendant risks and log recovery that even when things turn out well, often includes a period of 1-3 months of incontinence. My guess is that in over 90% of cases, Ruzum on big prostates works fine. As for Aquablation, it will probably replace TURP - the potential long term problems are much lower, bu tthe recovery is just as long. And its still in the experimental stage.
If you get Rezum and it doesn't work, it doesn't preclude anything else - I would find a doc that does it on larger prostates.
And ignore the outside/inside stuff on flow and trips to the bathroom. BPH is caused by an enlarged prostate blocking your flow. Open that up and you get relief - however they do it.
I don't understand why some men do Flomax or something like it along with CIC. If you're doing CIC there reallyl no reason to take drugs... unless you're trying to cut down on the frequency of cathing. Perhaps you're hoping to try to go without CIC and see if you can live without it eventually when the drugs kick in, if they do. I was concerned about the blood pressure effects of Flomax and other sides
I agree with everything lance said but because you are looking for something that is not covered by your insurance, I would recommend to look int PerFected PAE. It might cost you $6500-7000 out of pocket but has much less rsik of side effects and recovery time, althoug the longevity is not guaranteed, but so is TURP and RESUM. You can do it cheaper in Portugal and Brasil, but after the trip cost and hotel stay it boils down to the samy amount of money. There are a few centers in LA, NY adn NC that perfor PAE and even try to prequalify it with your insurance.
what u said make good sense.
turp and aquablation have many differences and the result is different as well.
Keith, I am doing CIC and taking Doxazosin. Yes, to reduce CIC frequency, 1/2 vs 4/5. Another reason is it feels good to be able to clean my plumbing by peeing naturally. I like the blood pressure side effects. Actually, I need it. Hank
Gene, did Medicare finally take care of your PAE bill ? Hank
i have incomplete understanding of this topic, but my understanding is that the proven ejaculation preservation technique work exactly opposite to what u had said. it avoids cutting tissue near the bottom of the prostate. also the jetwash thing is not a variant of laser. perhaps, i am just don't understand enough.
dl0808 - I disagree. They do pretty much the same thing via different techniques. The side effect profile is much better with Aquablation, but the end result and recovery time are similar. Some say Aquablation might take longer to recover from than TURP
i meant 93% NO retro. sorry.