Benign prostatic hyperplasia (BPH) is considered a common urological abnormality found in men aged 50 and older. When it occurs, it is characterized by causing various uncomfortable symptoms such as difficulty urinating, a persistent feeling of incomplete bladder emptying (residual urine sensation), and nocturia (frequent nighttime urination). Conventional prostatectomy has long been established as the standard treatment method, but the problem was that the results varied depending on factors such as the medical team's proficiency and the size of the prostate. Furthermore, many patients have felt burdened due to the risk of complications such as erectile dysfunction, retrograde ejaculation, and urinary incontinence.
In contrast, 'Aquablation (waterjet robotic surgery),' a newly introduced treatment method, is widely performed as it complements these aforementioned drawbacks. Aquablation is a technique that utilizes a high-pressure waterjet to precisely remove prostate tissue. Since this process does not generate heat, it can minimize damage to surrounding tissues.
Before Aquablation surgery, the operating surgeon precisely plans the resection area using ultrasound and endoscopy, after which the robot accurately and consistently removes the designated tissue. This procedure typically takes a short duration, averaging 7 to 15 minutes, and allows for same-day discharge, significantly reducing the burden of patient recovery. Notably, positive improvement results can be expected due to the low risk of urethral stricture or bladder neck contracture and its excellent effect on improving urinary function.
However, simply because it is a new treatment method does not mean it is unconditionally suitable for all patients. First, an assessment of individual patient suitability is necessary. Factors such as prostate size and shape, co-existing conditions, and anesthetic eligibility must be considered. A particularly cautious approach is required for elderly patients or those with underlying conditions like cardiovascular disease.
Furthermore, post-operative management is also crucial. Initially, symptoms such as frequent urination and changes in urination patterns may appear, but these generally resolve over time. In addition, regular follow-up observations and consultations with the medical team are necessary.
While robotic technology enhances the precision and consistency of surgery, it is still the medical team's role to formulate the surgical plan, ensure hemostasis, and manage the patient's overall condition. Therefore, choosing an experienced medical team is a key factor in increasing both safety and patient satisfaction.
Aquablation can be an innovative treatment alternative for patients with benign prostatic hyperplasia, offering a lower risk of complications compared to conventional surgical methods, faster recovery, and not being constrained by prostate size. However, a personalized treatment decision tailored to the individual patient's situation is necessary. The true benefits can only be expected when accompanied by thorough consultation before treatment and consistent post-operative care, supported by the medical team's expertise, as well as the patient's understanding and cooperation.
Director Kim Jae-woong, Goldman Urology Clinic Gangnam Branch