Most men over the age of fifty will develop an enlarged prostate. Also called benign prostatic hyperplasia (BPH), this troubling condition causes difficulty urinating and, if left untreated, can eventually result in other problems, resembling infection, kidney stones, and bladder damage. may cause There are many alternative BPH treatments available, including medications and various sorts of surgery.
One of the newer surgical options, called aquablation, trims away excess prostate tissue with highly pressurized jets of saline. Doctors perform ablation within the operating room while the prostate gland on an ultrasound machine. Patients are put under general anesthesia, so that they feel no pain throughout the procedure.
Men normally have to urinate through a catheter for about 24 hours after surgery until the swelling of the urethra (the tube through which urine leaves the bladder) goes down. Aquablation is gaining popularity—partly, because unlike other traditional BPH treatments, it could possibly preserve normal ejaculation.
In September, researchers published A study It shows that improvements in urinary function from ovulation are still maintained five years later.
Data evaluation results
The study evaluated long-term data from two clinical trials. The first, called the water trial (for Waterjet OhBlation TTherapy for EEndoscopic R(extraction of prostate tissue) began in 2015 and enrolled 116 men with prostates as much as 80 cubic centimeters. A second trial, WATER II, began in 2017 and enrolled 101 men with prostates between 80 and 150 cubic centimeters. (Normal prostate size ranges from 25 to 30 cubic centimeters.) The mean age of enrolled patients was 66 within the WATER study and 68 in WATER II. In addition, 92% of men within the WATER trial were sexually energetic, as were 75% of men in WATER II.
Both clinical trials used the so-called International Prostate Symptom Score (IPSS) to measure treatment-related improvements in urinary function and quality of life. Calculated based on how patients rate their symptoms on a standardized questionnaire, IPSS scores fall into three categories: mild symptom scores from 1 to 7; Intermediate symptom scores range from 8 to 18. And scores above 19 indicate severe symptoms.
When they first enrolled within the trials, men within the WATER and WATER II studies reported mean IPSS scores of twenty-two.9 and 23.3, respectively. Five years later, the mean corresponding scores were much lower: 7.0 and 6.8. The mean length of hospital stay was 1.4 days within the WATER group and 1.6 days for the WATER II group. Only 1% of men were taking BPH medications after five years, and lower than 5% were treated again with surgery.
Another one A randomized controlled trialWater III, is currently underway in Europe. The trial compared aquablation with a more established variety of BPH surgery, prostate enucleation, which uses a laser to remove the obstructing tissue. Six-month data reported in 2023 showed comparable improvement in symptoms in men in each groups.
However, 98% of men within the prostate enucleation group had ejaculatory dysfunction. This side effect is brought on by damage to the fragile tissue across the bladder neck that enables semen to pass out of the body. The semen subsequently returns to the bladder, a condition referred to as retrograde ejaculation. None of the lads within the ejaculation group reported problems with ejaculation.
A word of caution
Additionally, aquablation could also be inappropriate for some men who use blood thinners to stop blood clots, in line with Dr. Rayala. Candidates suitable for surgery “must be able to safely discontinue anticoagulant medications during postoperative healing, given the risk of bleeding,” Dr. Rayala said. Still, aquablation is an incredible option for many men, Dr. Rayala said, especially those with medium-to-large prostates “who want a durable solution with less risk of sexual side effects.”