Aquablation for Prostate Cancer

Aquablation therapy is currently primarily used for treating benign prostatic hyperplasia (BPH) – could it be used to treat prostate cancer?

Charles H. Weaver, MD
2–3 minutes
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Aquablation therapy is currently primarily used for treating benign prostatic hyperplasia (BPH). Clinical trials evaluating it as a potential treatment for early-stage prostate cancer are ongoing. The therapy involves using a robotically controlled, high-velocity waterjet to precisely remove prostate tissue. This method is guided by real-time imaging, usually combining ultrasound with a cystoscope, allowing for precise targeting and preservation of the surrounding tissues.1,2,3,4

  • Aquablation is predominantly used for the treatment of BPH, a non-cancerous enlargement of the prostate gland. It helps alleviate symptoms such as urinary retention and frequent urination.
  • Aquablation is minimally invasive and utilizes a heat-free waterjet, which reduces the risk of heat-related damage to tissues. This is particularly beneficial in preserving sexual and urinary functions.
  • Aquablation has been shown to be effective in improving urinary flow and reducing symptoms of BPH with a low risk of complications. It is noted for its precision due to the robotic control and real-time imaging.

Side Effects of Aquablation for Prostate Conditions

  1. Postoperative Bleeding: One of the most common risks observed in Aquablation therapy is post-procedure bleeding. Some patients may require transfusion or return to the operating room for postoperative hemostasis management, typically involving cautery.9
  2. Urinary Tract Infections (UTIs): Patients may experience UTIs following the procedure. This is a common risk associated with many types of prostate surgery and procedures and can be treated with antibiotics.2,5,6,8
  3. Difficulty Urinating: Some patients may experience difficulty urinating, including urinary retention or the need for temporary catheterization after the procedure.2,5,6
  4. Urinary Urgency and Frequency: Temporary irritative urinary symptoms such as urgency, frequency, and discomfort during urination are common but usually resolve over time.5,6,8
  5. Ejaculatory Dysfunction: While Aquablation has a lower incidence of sexual dysfunction compared to other prostate surgeries, there is still a risk of ejaculatory dysfunction, including retrograde ejaculation. However, the incidence is reported to be lower than with traditional surgical methods.5,6
  6. Pelvic Discomfort and Mild Rectal Discomfort: Patients may experience mild pain or discomfort in the pelvic area or rectum following the procedure, which typically resolves within a few days.5,6
  7. Risk of Injury to Urethra or Rectum: There is a low risk of injury to the urethra or rectum where the devices gain access during the procedure.5,6,8,9

Treatment of Prostate Cancer

The clinical trials PRCT001 and PRCT002 are evaluating the safety and performance of the AQUABEAM Robotic System for the resection and removal of prostate tissue in patients with localized prostate cancer, which includes stage II.4,7 These trials are ongoing and aim to provide more specific data on the effectiveness and safety of Aquablation as a primary treatment for prostate cancer.

References

  1. https://nyulangone.org/news/perlmutter-cancer-center-clinical-trial-tests-use-high-velocity-water-jets-treat-prostate-cancer
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5993070/
  3. https://www.auajournals.org/doi/10.1097/JU.0000000000003483
  4. https://classic.clinicaltrials.gov/ct2/show/NCT06051942
  5. https://www.procept-biorobotics.com/aquablation-therapy/aquablation-faqs/
  6. https://www.topdoctors.co.uk/medical-dictionary/aquablation
  7. https://www.mountsinai.org/clinical-trials/prct002-prostate-cancer-treatment-with-aquabeam-robotic-system
  8. https://aquablation.com/blog/enlarged-prostate-dangers/
  9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7073705/
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