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Health Matters: Providence Holy Cross Medical Center | 9 C ommitted to innovative procedures that ease the way for our patients, Providence Holy Cross Medical Center is offering the latest technology to safely treat enlarged prostates. Aquablation, a state-of-the-art robotic procedure, allows our physicians to tackle the largest of prostates with less pain, shorter hospital stays and reduced risk for incontinence or sexual dysfunction. In December 2021, Daniel I. Brison, MD, a urologist with Facey Medical Group/ Providence Holy Cross, conducted the first Aquablation procedure at the hospital, and he has since performed many more successful surgeries. Dr. Brison is currently training other physicians to use this technology, which he says is "revolutionary for benign prostatic hyperplasia (BPH) patients." WHY IS AQUABLATION SO SIGNIFICANT? By the time men reach the age of 60, they have a 50% chance of having an enlarged prostate. (Physicians, however, report treating men as young as 40.) Why does this matter? Because an enlarged prostate can cause symptoms including urgent, frequent urination and poor urinary flow. If left untreated, the prostate may continue to grow and create significant health problems, including blockage, irreversible bladder or kidney damage, bladder stones, urinary retention and/or incontinence. Previous surgical treatment options—even those utilizing the latest technology—on prostates larger than 80 grams (2.8 ounces) put men at risk of sexual dysfunction and urinary incontinence, as well as more pain from the procedure and longer recovery periods. Aquablation is a new solution that decreases such risks—giving men with larger prostates a pathway toward a vital and healthy future. "If a man has a prostate that weighs more than 80 grams, he has limited options. Several of the procedures offered are approved by insurance providers only for smaller glands and, if performed on bigger glands, carry increased risks and have lower success rates. In the past, the gold standard for prostates measuring less than 100 grams ounces) was an open simple prostatectomy, which was associated with a prolonged recovery period and higher risks of complications," Dr. Brison explains. "It required physicians to open the bladder. The patient would need a catheter for two weeks, experience significant blood loss and expect hospitalization for three days to a week. We later introduced procedures such as robotic simple prostatectomies and laser prostatectomies (HoLep), which made some improvement, but now Aquablation has changed all this." It is now approved by Medicare and the FDA and shows great promise. HOW DOES AQUABLATION WORK? The procedure is robotic in the sense that it is computerized and allows physicians to map out the prostate in two dimensions. It has a urethral handle that provides precise vision to identify exactly where to start and end the treatment without adversely touching tissues associated with bladder control. "The results are better, recuperation times shorter, the catheter is removed in three days and hospitalization is one night. So far, we're seeing 98% accuracy without any significant incontinence or sexual dysfunction issues. It's a great option," Dr. Brison asserts. JUST ASK DANIEL R. CAHILL The 63-year-old sales manager for an automotive aftermarket company in Thousand Oaks received Aquablation in January. When he went to see his urologist for bloody urine, he discovered that his prostate was especially large, measuring 105 grams. After an evaluation, two cancerous tumors were discovered in Cahill's bladder. The surgery needed to remove the tumors was deemed too risky, because of the size of his prostate. Cahill was referred to Dr. Brison for the newly approved procedure, which was performed without affecting other tissues in his bladder—something not feasible just a year earlier. "I didn't take any pain pills after the procedure. I don't remember any pain after leaving the hospital, either," says Cahill. "I love the guy [Dr. Brison]. He's an awesome doctor, and I'm so fortunate to have found him." The procedure was performed on a Friday in January. Cahill was released with a catheter that was removed three days later. Had Cahill received the typical surgery, it would have required a week's hospital stay, pain meds, catheter use for two weeks and potential side effects hindering his quality of life. "I felt fine after surgery. I had no pain at all," says Cahill. "More importantly, I've had no side effects. I've had no problems with incontinence or sexual side effects at all. I'm so lucky."

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