One of the biggest health problems plaquing half of all men in the U.S.by the time they are 50 - enlarged prostates - also called benign prostatic hyperplasia.
“I was getting up all night to go to the bathroom, I had absolutely no quality of life,” says Nick Caballero. “Tests revealed that the problem was my prostate. It was much larger than it should have been.”
The walnut-sized gland never stops growing but after a certain point, the symptoms of a prostate that has become too large, like the following, can be very disruptive:
- Sudden inability to urinate
- Urinary tract infections
- Urinary stones
- Damage to the kidneys
- Blood in the urine
In Jonathan’s case, his enlarged prostate was pressing on his bladder causing him to retain urine. “Traditional treatments, like certain medications and surgery can have undesirable side effects that I was not looking forward to,” explains Nick.
But now, urologists at Hackensack University Medical Center are offering an innovative treatment that uses a high-intensity waterjet to destroy (ablate) excess prostate tissue that causes uncomfortable symptoms for many men.
Called Aquablation®, the therapy is an option for men whose prostate enlargement cannot be effectively treated using prostate-shrinking medications. Aquablation is performed using a robotic surgical platform, guided by real-time imaging to deliver treatment with extraordinary precision.
Aquablation is indicated for any man whose prostate is causing an obstruction, and who cannot achieve relief with medication or do not want to take these drugs. "Aquablation is as effective as these other treatments but with fewer side effects, including only a 10-15% risk of retrograde ejaculation," explained Ravi Munver, M.D., vice chair of Urology at Hackensack University Medical Center. "Because it is performed using the surgical robot with ultrasound guidance, it can be completed more rapidly, and with a level of precision that is reproducible from surgeon to surgeon. You can see where the prostate capsule ends and remove more excess tissue. Aquablation is the only heat-free ablation approach available to treat BPH."
Here's how it works: The patient is asleep under anesthesia. An ultrasound probe is inserted into the patient's rectum to produce clear real-time images of the prostate. The addition of ultrasound imaging enables the surgeon to map the parts of the prostate to remove and the parts to avoid. The Aquablation scope is inserted into the urethra. When ready to begin, the surgeon presses on a pedal and the Aquablation system advances to the prostate, delivering a heat-free waterjet so intense that it can remove the prostate tissue that has been mapped out. See a video of Aquablation in action.
“Depending on the size of the prostate, the procedure may take as little as 15 minutes,” said Michael D. Esposito, M.D., co-director of Robotic Laparoscopic and Endourology Followship at Hackensack University Medical Center. Dr. Esposito explained the patient stays in the hospital overnight with a urinary catheter and may go home as soon as the next day. Patients report feeling a reduction in BPH symptoms right away and are able to go off their BPH medications. “Aquablation achieves years of prostate relief, and we’re thrilled to offer this new option to our patients.”
“There were no incisions of any kind, the procedure was less than an hour,” says Nick who says he spent only one night in the hospital.”It was a success! I knew two weeks into it that it was a success but I wanted to wait so I wouldn't jinx myself.”
High-tech treatments such as Aquablation are best suited to centers with expertise and high volumes in the field of robotic surgery. "For years, Hackensack University Medical Center has been a national leader in the use of robotic surgery, especially for urologic procedures, and we have trained many other surgeons in its use," noted Michael Stifelman, M.D., chair of Urology. "We are proud to be the first in northern New Jersey to offer this innovative treatment to restore comfort and quality of life to men with BPH."
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