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Treatment and Procedures

Aquablation

We are excited to be pioneering a truly game changing treatment for treating Benign Prostatic Hyperplasia (BPH) and Neil Barber has been involved in the trials of this unique and novel procedure. Neil is a recognised world key opinion leader on this technology, and continues to present and teach on the technique around the across Europe and the US, with visiting surgeons coming to the UK to see this procedure in action He is the only UK based urologist who is both faculty and member of the newly established Society of Benign Prostate Disease – SoBPD. Since 2014, Neil has been performing aquablation in and out of studies and has currently performed over 300 cases.

This video introduces Aquablation and why it might be right for you


Neil Barber provides the low down on the procedure in this short video, including the differences between this treatment and more traditional BPH treatments.

Aquablation, delivered by PROCEPT BioRobotics™ AQUABEAM® System, uses a robotically controlled waterjet to remove prostate tissue without the application of heat.

The AquaBeam system is a first of its kind, image-guided system delivering a treatment utilizing water and robotics for the targeted removal of prostate tissue. AquaBeam combines image guidance and robotics to deliver Aquablation, a personalized waterjet tissue resection modality. Under real-time image-based ultrasonic guidance, AquaBeam enables surgical planning and mapping, and allows for a controlled resection of the prostate with a high-velocity saline stream. The combination of surgical mapping and controlled resection of the prostate is designed to offer predictable and reproducible outcomes. Further information can be found at https://aquablation.com/

 

Watch this video from PROCEPT for a step by step guide to the Aquablation procedure

Medical Evidence

There is high quality evidence from a number of large trials across the world to support the efficacy and safety of Aquablation as treatment of symptomatic BPH. This includes peer reviewed publications and in a prospective real world study across Europe, confirming

  • maintenance of improvement in symptoms with 3 years follow up,
  • efficacy on larger prostates (volumes 80 to 150 mls), including men with catheters in place and in those with poor bladder emptying and in all sizes of prostates.

Putting all this high quality data together, analysis confirms reproducible outcomes in all sizes and shapes of prostates and circumstances with a 10% chance of dry ejaculation and uniquely, no risk of negative impact upon erectile function.

This means that the level of symptom and urinary flow improvements with Aquablation are TWICE as good as for the minimally invasive alternatives, including, Rezum (steam ablation) but still achieving a very low risk of effecting sexual function.

A summary of the reported findings of the WATER Study comparing Aquablation to TURP (current gold standard treatment) includes:

  • Significantly improved BPH symptoms in both treatment groups as measured by the International Prostate Symptom Score (IPSS) at six months with 100% of Aquablation patients improving from baseline
  • Superiority in IPSS storage symptom sub-scores (p<0.05)
  • Superiority in IPSS improvement with Aquablation in men with prostate volume greater than 50 ml as compared to TURP (p<0.01)
  • Superiority in peak urinary flow rates (Qmax) at six months
  • A significantly lower rate (4 to 1 ratio, p<0.001) of sexual side effects in Aquablation compared to TURP at three months
  • Superiority in ejaculatory function (MSHQ-EjD) and incontinence scores (ISI) at three months

In summary, the results are indicating outcomes like TURP and laser treatment but with a far lower risk of sexual dysfunction and speedier recovery. In fact rather than the expected 60 -70% chance of dry ejaculation seen with TURP or laser prostatectomies, aquablation using a non heat technique was associated with a 7% chance of dry ejaculation.

In February 2022, the WATER trial released five year data - you can read the full article here on our news page

Neil Barber is the only surgeon in the world able to offer this treatment privately to self funding patients through The London Clinic. To find out more details and to book a consultation with Neil, please contact his secretary here.

Neil is also carrying out trials for the procedure with patients at his NHS practice at Frimley Park hospital.

Now in July 2022, Richard Hindley has also begun been trialling the procedure at North Hampshire Hospitals in Basingstoke. BBC South Today covered the first procedures he performed and the impact this could have on reducing NHS waiting lists. You can watch the news coverage here

Richard will be planning to offer this treatment at The Hampshire Clinic and can see patients for a consultation. Please contact his secretary here for further details. 

The following consultants offer this treatment:

Neil Barber; Richard Hindley;