Could Water-Jet Technology be the Solution for Your Patients with BPH? [Q&A]

A native of West Virginia, Lynnetta Faith Payne, DO, is a urologist committed to bringing innovative surgical interventions to patients in rural communities who might otherwise not have access to today’s top technologies.

Dr. Payne’s practice at Raleigh General Medical Group in Beckley is one of only three in the state of West Virginia to offer Aquablation, a relatively new minimally invasive surgical treatment for benign prostatic hyperplasia (BPH). Aquablation extends benefits to patients above and beyond what many other procedures provide.

Currently performing an average of 12 – 15 Aquablation surgeries a month, Dr. Payne has experienced such great success with the technology that she and her team are in the process of transitioning to Aquablation as their primary surgical intervention for BPH.

We sat down with Dr. Payne recently to discuss how she utilizes Aquablation to reduce or eliminate symptoms of BPH and significantly improve the quality of life of her patients.

Q: What is Aquablation therapy? How do you perform it at Raleigh General Medical Group?

Dr. Payne: Aquablation is a minimally invasive procedure for the treatment of BPH. It is one of the surgical options in a hot new category called MIST (minimally invasive surgical techniques). Aquablation is a real game-changer because it can be performed quickly, preserves sexual function, and helps patients remain continent.

During Aquablation, the surgeon uses ultrasound to map out the specific obstructive tissue intended to be removed. The tissue is then removed precisely and efficiently using robotic water-jet technology. The robot is designed to deliver a consistent amount of pressure every single time, based on a patient’s specific anatomy and how the tissue has been mapped out. If the patient has a 150-gram prostate or a 30-gram prostate, the robot makes the correct calculation about how much water jet pressure is used.

The surgeon is in control at all times during procedures. The waterjet pressure can be stopped or adjusted in a millisecond.

Think of Aquablation like a pressure washer or a car wash. The jet ablates the tissue automatically based on the intraoperative surgical mapping and evacuates it out into a container. The channel is now opened up. It’s amazing.

Q: How does Aquablation compare with other procedures you perform for the treatment of BPH?

Dr. Payne: Aquablation requires much less anesthesia time, has a far quicker recovery period, and has a lower side effect profile in terms of sexual dysfunction and incontinence. It also has one of the lowest retreatment rates compared to other types of therapies, about 1% per year after surgery.

With Aquablation, I can remove a 150-gram prostate – which would typically take me about 90 minutes during TURP (transurethral resection of the prostate) – with a resection time of about 6.5 minutes.

It’s a nice minimally invasive way to remove a lot of tissue in a short amount of time with low side effects.

Q: How satisfied are your patients with Aquablation?

Dr. Payne: The level of patient satisfaction with Aquablation has been incredible.

I think what men want is the ability to get back to the way they were before they presented with BPH. They want to go to the bathroom and not worry about it. They want to use the restroom without fearing they’re going to have to stand there for minutes and minutes to get their urine out. It’s very stressful.

One patient told me how important using a urinal instead of sitting on the toilet was to him. After his Aquablation procedure, he went to the airport and was so proud he could actually stand at the urinal. It’s a life-changing thing.

Q: What side effects are men most concerned about with other procedures? How does Aquablation help you address their concerns?

Dr. Payne: One of the most important things for many men is maintaining their sexual function after the procedure, namely, their ability to ejaculate. It’s a natural concern and we talk about it very openly and candidly.

The first portion of the procedure is dedicated to surgical mapping, and it is at this point that an ultrasound is used to define boundaries to contour the prostate tissue to be ablated. This is very precise and designed to preserve and protect key anatomic areas. During surgery, the surgeon then makes a butterfly cut at the apex of the prostate and to preserve the ejaculatory duct. There is no heat used at that area.

This is what makes Aquablation different.