Major Advanced Therapeutic Aquablation in Prostate Treatment – 32963 Features, Health


If you’re a man over 50, chances are you already have or will soon develop an enlarged prostate. It’s just a natural part of aging. But at some point, it can lead to an uncomfortable condition called benign prostatic hyperplasia (BPH).
The good news is that BPH is not prostate cancer and does not make you more likely to get it. And there are many treatments for BPH, from lifestyle changes to medications to surgery.

“An enlarged prostate is a natural occurrence and any man who lives long enough will eventually get it,” explained Dr. Justin Muskovich, urologist at HCA Florida Lawnwood Hospital. “It happens in response to the production of testosterone throughout our lives.

“Our urethra, the tube that carries urine out of our penis, runs through the center of our prostate, so when the prostate naturally grows, it starts to get clogged. The way we feel about the enlargement of the prostate passes through our bladder. It’s like taking a free-flowing garden hose and squeezing it. You have to put more pressure on it to release the same amount of water.

“Our bladders work the same way. When this blockage occurs, our bladder muscles have to generate more force and eventually the bladder will thicken causing spasticity and irritation. Untreated, BPH can cause urinary tract infections, bladder or kidney damage, bladder stones, and incontinence.

Obstructive symptoms of BPH include difficulty starting to urinate or having to stop and start repeatedly; having to strain or push when urinating; and have a weak stream of urine.

Symptoms of BPH caused by changes in the bladder include urgency to urinate; a high frequency of urination; the feeling that even after leaving, you have the impression that your bladder is not empty; and waking up often at night to relieve themselves.

“The main reason to treat BPH is to protect the bladder over the long term,” Dr. Muskovich said. “As the prostate grows, the treatment becomes more complex. That said, overall prostate size does not necessarily correlate with symptom severity. I’ve seen small prostates with big problems and big prostates with no problems. The treatment, however, is based on size.

Although certain lifestyle changes, such as drinking less caffeine and alcohol and less fluids before bed, can ease some of the symptoms, there are medications and minimally invasive options that may be more effective.

Minimally invasive options include:

  • Rezum Water Vapor Therapy, which injects steam into the prostate gland causing excess prostate tissue to die.
  • Transurethral microwave therapy, which uses microwave heat to remove excess prostate tissue.
  • Laser treatments that vaporize excess prostate tissue by projecting laser energy from inside the prostate.
  • Transurethral resection, which removes all but the outer part of the prostate by cutting and shaving off pieces of the prostate with a scope.

“The problem with some of these procedures is that the nerves that control sexual orgasms, erectile function and ejaculation run just outside the prostate, so any procedure that uses thermal energy has the potential to transmitting that energy to those nerves,” Dr. Muskovich continued. . “Heat damages nerves and some of these procedures have the potential to interfere with sexual function.”

If the prostate is too large for the treatments listed above, a surgical procedure called a prostatectomy can be performed using open or robot-assisted surgical techniques to cut out the excess prostate tissue.

But now there is another option.

“Rather than doing open surgery for very large prostates, there is a new technique called robotic aquablation therapy, which uses high-pressure jets of water without heat to remove prostate tissue. While a simple prostatectomy can take two hours under general anesthesia, this procedure can achieve the same results in about five minutes, moreover, it has no impact on erectile function, orgasmic function and sexual desire.

Aquablation therapy is the only procedure that uses a cystoscope (a camera that goes through the urethra into the bladder) in combination with ultrasound imaging to allow the surgeon to see the entire prostate (from inside the prostate) during surgery.

Using ultrasound to map the prostate, the robotic system offers the treatment. It tells where to spray water and how much tissue to remove, and monitors it in real time.

It is also designed so that when it gets close to the muscles controlling sexual functions, it changes how they work to preserve ejaculatory function.

“We are the first hospital in Central Florida and the first HCA facility on any of the coasts of this country to have this machine,” Dr. Muskovich said proudly.

“For HCA to invest so much in this cutting-edge technology is an incredible resource for people in this field. With aquablation therapy, we have the ability to accurately reproduce results and eliminate human error from the equation. As confident as I am in my surgical skills, I know I won’t do as well as a very finely tuned machine.

Dr. Justin Muskovich received his medical degree and completed his surgical internship and urology residency at the University of Toledo School of Medicine. He is trained in the use of minimally invasive treatment modalities for the treatment of kidney stones, bladder stones, bladder tumors and enlarged prostate. He is affiliated with HCA Florida Lawnwood Hospital and HCA Florida St. Lucie Hospital, and his office is located at the Heart and Family Health Institute, NW Peacock Boulevard, Port St. Lucie. For an appointment, call 772-336-6601.

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