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Desai Sethi Urology Institute Offers Robotic Aquablation Therapy for BPH

The image-guided treatment for benign prostate hyperplasia is a viable alternative for men who want to avoid transurethral resection or oral medications.

The Desai Sethi Urology Institute (DSUI) at the University of Miami Miller School of Medicine has added Aquablation therapy to its array of proven treatment options for benign prostate hyperplasia (BPH).

Bruce R. Kava, M.D.
Dr. Bruce Kava says Aquablation therapy is an option for men concerned with medication and surgery side effects.

DSUI’s new AquaBeam Robotic System is the first FDA-cleared surgical robot that automates tissue resection to treat lower urinary tract symptoms in men who have BPH, according to Bruce R. Kava, M.D., professor of urology, director of men’s health at DSUI and president-elect of the American Society for Men’s Health.

“Many men choose to do nothing and suffer with BPH symptoms because of their concern about drug- or surgery-related side effects,” Dr. Kava said. “Aquablation therapy is an option that addresses those concerns with proven results.”

What is BPH and How is it Treated?

BPH, or enlarged prostate, affects about 50% of men between the ages of 51 and 60 and up to 90% of men older than 80. Men with BPH might experience difficulty or changes in urination, including sudden urges to urinate or frequent urination, which makes it hard to get a good night’s sleep. Nearly all–99%–of men with BPH say the symptoms impact their quality of life.

There are several treatment options for BPH, including oral medications that have been shown to improve symptoms in 30% to 60% of men with enlarged prostate. But 40% of men are unhappy with or don’t tolerate available oral medical therapies and are looking for minimally invasive approaches that can be done rapidly and result in a quick convalescence and better voiding without having to be on lifelong therapy, according to Dr. Kava.

“The gold standard for treating BPH is a surgical procedure called transurethral resection of the prostate, or TURP,” Dr. Kava said. “TURP works extremely well but can result in side effects that upset some men, including ejaculation issues, such as the lack of ejaculation, and in rarer cases it can result in erectile dysfunction.”

Aquablation Therapy’s Image-guided Precision

Aquablation therapy (Procept Biorobotics) is similar to TURP. Instead of using a surgical instrument to pass through the urethra and into the bladder, Aquablation uses a water jet.

Image of the treatment area, including a surgical map of the prostate, during Aquablation therapy.
Aquablation therapy uses a water jet, rather than surgical instruments, to treat benign prostate hyperplasia.

Aquablation therapy is an image-guided, automated, heat-free robotic therapy, according to Dr. Kava.

“The device’s real-time ultrasound imaging provides surgeons a multi-dimensional view of the prostate, which allows us to use the water jet to shave and contour the prostate according to the individual’s anatomy,” Dr. Kava said. “Using this relatively new but studied technology, we can perform a very precise resection of the obstructing tissue, while preserving ejaculation and sexual function better than with TURP.”

BPH patients who are treated with Aquablation therapy often find they can void at a more rapid rate, empty their bladders more completely and have fewer, if any, symptoms related to enlarged prostate.

Studies Support Aquablation Therapy Efficacy

Published studies looking at five-year data suggest that Aquablation therapy is safer and about as effective as TURP in men with BPH.

“We now offer the entire armamentarium of BPH procedures, including oral and minimally invasive options, surgical TURP, as well as laser approaches,” Dr. Kava said. “The bottom line is one size doesn’t fit all. Everybody has a list of items that are important to them, and with that information we can map out their best BPH treatment option.”

Tags: BPH, Desai Sethi Urology Institute, Dr. Bruce Kava, robotic surgery