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Seniors Series: New prostate treatment technology debuts in Tri-Valley

Aquablation therapy offers hospital additional precision in treating enlarged prostates

San Ramon Regional Medical Center is one of the first in the area to offer a robot-assisted treatment for an enlarged prostate condition that is most common in men over 50 years old.

Aquablation therapy is aimed at providing urologists a new tool that offers increased precision and other benefits in the treatment of benign prostatic hyperplasia (BPH), a non-cancerous condition in which the prostate enlarges and creates complications in the lower urinary tract.

"We are proud to offer a solution for men with BPH that can provide relief without compromise," said Ann Lucena, CEO of San Ramon Regional. "Aquablation therapy is the next step in expanding our robotic surgical services and furthering our commitment to men's health."

According to SRRMC urologist Dr. Christopher Welty, the technology is new to the Bay Area, with only one or two other setups in hospitals throughout the East Bay. But while the technology is still newer than other treatment options, Welty noted that it has been around long enough for five-year followup data to be available.

Compared with what is considered the "gold standard" -- transurethral resection of the prostate, or TURP -- Welty said that a recent study showed aquablation to offer equal or lower rates of retreatment, and that it was generally better at offering relief from symptoms.

"There's a lot of treatments right now for BPH," Welty said. "TURP was the gold standard, though a lot of us don't use that very much any more because there's a lot of options and having aquablation available gives us another tool."

Welty said that in particular, aquablation therapy has the benefit of being able to treat all prostate sizes, while some other treatment options are less effective for larger prostates.

When left untreated, BPH can lead to increasingly severe complications in the urinary tract, with the enlarged prostate obstructing the flow of urine, leading to the inability to pass urine and kidney dysfunction in severe cases.

"Not all men, but a lot of men as they get older, their prostates get larger, and sometimes when their prostates get larger it blocks the urethra," Welty said. "So they can have a harder time emptying the bladder, and it also can lead to some bladder dysfunction because the bladder is working harder to get the urine out so they have to go more frequently or more urgently."

Welty said that most of his patients come to SRRMC at the advice of their primary care doctors, or in some cases, when the condition has gone untreated to the point where they can't urinate at all.

"For an enlarged prostate, the main goal here is quality of life, but a lot of men tend to postpone looking for treatment thinking either that medications are going to have lots of side effects, or treatments are going to have lots of side effects," Welty said. "Sometimes men have heard about their friends getting treated for prostate cancer, and this is very different."

While the risk of BPH is generally higher in men over the age of 50, Welty said that this can vary widely, with patients experiencing their first symptoms anywhere between the ages of 40 and 70. He noted that primary care doctors will generally start asking screening questions about prostate health as men enter their 40s.

"The main risk factor is age and just being a man," Welty said.

While genetics can play a role in prostate health, Welty said that for BPH, diagnosis and treatment were based on symptoms reported by patients, with no blood or genetic screenings for the disease.

"Family history is definitely a risk factor," Welty said. "It just tends to run in families. But just because someone's dad had their prostate operated on for an enlarged prostate, if they don't have any symptoms, there's no extra screening to do."

Welty noted that while aquablation offers advantages, including increased precision from real-time imaging and the ability to treat a wide range of patients, it is one of many treatment options for BPH.

"You have to talk to a urologist to find out if it's going to be the right thing, but even then there's a lot of options," Welty said.

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