Best procedure for an enlarged prostate - Aquablation. Live recording, 280 grams with prior Urolift

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One of the best procedures to treat an enlarged prostate is Aquablation. Check out this live case demonstration by Dr. Mehan. This patient has a humongous prostate, measuring 280 grams (around the size of a grapefruit). He also had a Urolift procedure performed a year prior which did not help. He sought a second opinion with Dr. Mehan and is here for Aquablation. This surgery took 35 minutes from start to finish and he did great.
Dr. Mehan has been offering Aquablation since 2019 and was the first to bring the technology to Arizona and the Southwest. He has performed over a hundred cases and teaches the procedure to urologist across the United States. This is a live case demonstration with other urologists in the operating room and watching remotely.
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CONTENTS
00:00 - intro
00:20 - place the ultrasound probe in the rectum
01:43 - insert the AquaBeam Scope in the urethra
04:17 - align waterjet nozzle
06:00 - place depth markers
06:23 - fine tune 1st treatment profile
06:54 - start 1st treatment cycle
11:30 - fine tube 2nd treatment profile
12:39 - start 2nd treatment cycle
17:16 - remove AquaBeam Scope
17:24 - insert resectoscope
18:35 - irrigate clots
18:59 - focal bladder neck cautery with Urolift removal
35:49 - check out the channel
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HOW DOES AQUABLATION THERAPY WORK?
Aquablation therapy is a resective procedure, which means that the prostate tissue causing symptoms is surgically removed. No incision is made in the abdomen, as the prostate is reached through the urethra.
Aquablation therapy is performed in a hospital and is done under anesthesia. The procedure typically takes less than 30 minutes. Most patients are discharged home after, but some require an overnight stay.
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STEP 1. CREATING A SURGICAL MAP
Every prostate is unique in size and shape. Aquablation therapy enables Dr. Mehan to customize your procedure to your specific anatomy.
How? Aquablation therapy is the only BPH surgical procedure integrates ultrasound imaging with the standard camera (called a cystoscope). This gives Dr. Mehan the ability to see the entire prostate in real time, which allows him to map which parts of your prostate he wants to remove and which parts he wants to avoid.
Specifically, this mapping enables Dr. Mehan to avoid removing the parts of the prostate that cause irreversible complications like erectile dysfunction, ejaculatory dysfunction, and incontinence.
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STEP 2. REMOVING THE PROSTATE TISSUE
Dr. Mehan has created a surgical map, a robotically-controlled, heat-free waterjet removes the prostate tissue that was outlined on the map. This robotic technology minimizes human error in removing prostate tissue, and ensures the prostate tissue is removed precisely, consistently, and predictably.
When required, Dr. Mehan may choose to use a minimal amount of cautery following an Aquablation procedure to control bleeding. In the case the Urolift implants are needed to be removed which took extra time and cautery.
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Please follow Dr. Mehan on his channel and subscribe for more information! Also, check out his Instagram stories on Doctor.Mehan for live surgery! Dr. Mehan enjoys educating and demystifying his art and craft.
Call today for a consultation with Dr. Mehan
480-219-1010
East Valley Urology Center
6116 E. Arbor Ave., Suite 108
Mesa, AZ 85206
Serving Arizona, Phoenix, Mesa, Gilbert, Queencreek, Chandler, Scottdale, Payson, Flagstaff, Sedona, Tuscon, Suprise, Glendale and beyond!

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4 авг 2024

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Комментарии : 53

@johncraig5397 Месяц назад

I found this fascinating! I had Aquablation in May of ‘24 with excellent results. Thankfully, no Euroclips in me. Watching this before my procedure made me feel totally at ease. I experienced absolutely no pain. There was a lot of discomfort from the catheter at the entry point which was gone the moment the catheter was removed. Spent the night, released the next day with first follow up two days later when the catheter was removed. Resumed normal activity, and I’m a very active 74 year old, when the urine ran clear after being quite red, then pink and lighter and lighter. It’s important to check the semen for bleeding as well. Finally, I loved listening to Dr. Mehan’s play by play commentary. He really is an artist!

@lhbrode 14 дней назад

Dr. Mehan completed my Aquablation procedure on July 11th. I had the exact same experience that you had no blood on day 9, no pain other than the annoyance of the catheter. Went to the Hollywood bowl last night and peed once. 68 years old and it is a whole new world.

@MarkBrown-uf8ct Месяц назад

Had it in Jan 24. Had a 205gm prostate. Amazing results.....

@ZePereira2000 26 дней назад

Amazing how it works and I've been through that procedure recently in February 2024.

@rexmurray622 4 месяца назад

Wow! I am a new patient of Dr. Mehan's waiting to get scheduled for aquablation. I have now enlightened myself as to what I will be going through. I am fortunate to have Dr. Mehan. I have confidence that I will be getting the best care available.

@mattfoley6082 9 месяцев назад

I had enlarged prostate 105cc. My IPSS score was 25 (bad symptoms with poor quality of life). In May 2022 I had an aquablation to remove excess. Huge difference. My IPSS is now 4. Back to normal. However, I now have stage 3 chronic kidney disease. The reason is I waited too long to get the surgery. For a couple of months my bladder was not emptying fully. I did not realize this was a danger but more important none of my doctors warned me of the danger. Before surgery my blood test showed dangerously high creatinine level so doctor told me to go to ER and get catheter in to empty bladder. The catheter worked, my bladder emptied and my creatinine level came down but the damage was done. If you have an enlarged prostate that is making it hard to pee you need to tell your doctor/urologist. He can check to see if your bladder is emptying. I highly recommend aquablation for fixing enlarged prostate.

@anxietysimplifiedpodcast3489 5 месяцев назад

Wow Great video

@33Donner77 10 месяцев назад

I recently turned down a Urolift recommendation. Patient satisfaction is 2 out of 5 for Urolift. Still checking options.

@IAmTheEggMan111 9 месяцев назад

I had urolift done 18 months ago and I am already deciding on which treatment I want to do next. The urolift is not very effective

@lytnin88 11 месяцев назад

Didn't the surgeon know that the patient had had a urolift? He acted like he was surprised to see the urolift.

@doctormehan7218 10 месяцев назад

I was surprised! I large number of my patients travel to Arizona for surgery with myself. This patient failed to inform before had that he had the Urolift procedure in the past. It worked out just fine.

$@arnoldfrackenmeyer8157$

@arnoldfrackenmeyer8157 9 месяцев назад

So then the aquablation is like a pressure washer ablating tissue? then you have to follow with the TURP to shave the fluffy tissue smooth. Or at least in this case of 280 grams. But what about patients who are 80 grams or less?

@NotAsTraceable 21 день назад

Will they let you take the ultrasound probe home?

@glennkarn9208 Месяц назад

Can anyone tell me if aquablation is available in Washington State?

@italopellegrino6122 10 месяцев назад

does the operation with aquabeam preserve all the functions? to what extent? Furthermore, does it make it more difficult later to ascertain any prostate cancer that may have occurred or not? I also heard that the aquabeam procedure makes radiotherapy unfeasible.

@doctormehan7218 10 месяцев назад

In their FDA trial, the risk of urinary incontinence and erectile dysfunction afterwards is 0%. There is a small risk of permanent retrograde ejacualtion at 7%.

@doctormehan7218 10 месяцев назад

I recommend Aquablation to men with prostate cancer who desire radiation treatement, but are now suffering from bothersome lower urinary tract systems. It is important to open the prostate up before radiation is given.

@TheManFromKansas 10 месяцев назад

@@doctormehan7218 Doc, what if the cancer patient has had radiation already? could patient benefit from the Aquabalation surgery?

@dannyboy34677 10 месяцев назад

How do you remove those pieces of urolift once you remove them?

@doctormehan7218 10 месяцев назад

It is washed out through the scope! The urethral end piece is actually quite small, around 8 mm.

@jamesdavis2284 8 месяцев назад

Hello Dr. Mehan. I'm 69 years old. My IPSS score is 32. According to my urologist in Washington State, my prostate is 98 grams and I have a large intravesical protrusion and no median lobe. Due to the size, he told me I am a poor candidate for Urolift or Rezum. I'd like to maintain antegrade ejaculation. Would Auqablation be a good procedure for me? Do you suggest patients bank their own blood due to possibly needing transfusion in case of bleeding? If I come to Mesa for this procedure, how far out are you scheduling? Thanks.

@doctormehan7218 8 месяцев назад

I try not to give medical advise through RU-vid comments. In general, Aquablation is a great option for men with large intravesical protrusions from BPH. This is the best resective procedure for men with a larger prostate who want to minimize their risk of having retrograde ejaculation. In my series, this risk is around 7%. Bleeding is also a risk, but in my series, the risk is very low, less then 1%. I do not have patients bank blood before as this is not needed. I see patients from all over the US and beyond. I'm booked for surgery this year, but could see you in January if you are willing to travel. Please call my office at 480-219-1010. I wish you well with whatever you decide.

@jamesdavis2284 8 месяцев назад

@@doctormehan7218 Thanks for the quick reply. My insurance will be changing in January and will cover your practice at that time. I'll call your office tomorrow.

@glennkarn9208 Месяц назад

Hello James, I am also 69 years old with a enlarged prostate (don't have a measurement as of yet, seeing a urologist soon). I was wondering if you had the procedure aquablation and how it worked out for you, as I am going to ask about it when I see my urologist. I am also in Washington State and was told Overlake has the machines for this proceedure so hopefully would not have to go out of state.

@MarkBrown-uf8ct 14 дней назад

@@jamesdavis2284 do it James. You will be pleased with the results. I know I am....

@janetw9430 11 месяцев назад

Does it shrink the prostate or carve it out, like a pumpkin?

@doctormehan7218 10 месяцев назад

🎃

@45651121 Год назад

I'm still confused as far as where is the probe in the flushing being done... are you in the urethra and what is the scraping scraping off.... if it's in the urethra why does scraping of the urethra is needed when it's being pushed in by the prostate gland or are you inside the prostate gland scraping or are you outside do urethral I don't get it🙄🙄🙄🙄🙄🙄🙄🙄🙄

@doctormehan7218 10 месяцев назад

I’ll work on making a video to best answer your question. This procedure totally obliterates the urethra in the prostate. The body will form a new urethra in the resected channel of the prostate afterwards

@jamescalifornia2964 9 месяцев назад

@@doctormehan7218 Very interesting. Thanks ... 👍

@glongshot Год назад

Does that orange part include two ejaculatory tissue when mapping? The Aquablation procedures preserve two ejaculatory tissue or only one when contouring?

@a2b3c Год назад

maybe it goes a bit left and also to the right of the VM, having this the 29th - but mine is only like 65g

@glongshot Год назад

@@a2b3c Can you tell the users directly, the Aquablation procedure preserves two ejaculatory ducts or only one?

@italialibera2102 11 месяцев назад

@@glongshotit does

@Roland-rv9cw 11 месяцев назад

I've been doing alot of research they say this is the best procedure. Here in IDIOT Canada only 2 place do it Ontario & Montreal not covered by our shit medical 1 place wants $ 22k 😡 the other if not a mistake $ 6,500. But pretty booked up 😮. I'm starting to look at the Philippines.

@Roland-rv9cw 11 месяцев назад

Rezum I think is very similar but use hot steam can damage nerves but Aquablation uses cold water spraying the Prostate tissue away like blasting water into a sand hill.

@antonioluis5543 2 месяца назад

Estou para ser operado com essa tecnica alguem me pode dizer em questao á vida sexual fica normal?

@gemb1101 4 месяца назад

Anyone could tell how much does this operation cost?

@doctormehan7218 4 месяца назад

This is covered by Medicare and most insurance plans.

@MarkBrown-uf8ct 14 дней назад

@@doctormehan7218 Thank God for that because it isn't cheap. However, it is worth every penny.

@Roland-rv9cw 11 месяцев назад

How much money 💵 there in the USA ?

@doctormehan7218 10 месяцев назад

I have treated a large number of men from outside the United States. The rate is determined by the hospital. Please contact my office and we can discuss further if you are interested

@Roland-rv9cw 11 месяцев назад

I'm confused also 🤔 i thought it's 1 or The other Turp & Aquablation.... Hmmm...

@doctormehan7218 10 месяцев назад

At the end of the Aquablation procedure, I use TURP to remove Urolift implants and for focal bladder cautery to minimize bleeding.

@Roland-rv9cw 11 месяцев назад

I heard there could be bleeding...😮 1 women on another video said her husband had severe bleeding was rushed to hospital.

@doctormehan7218 10 месяцев назад

Bleeding is common afterwards, but this will resolve with time. Severe bleeding is rare. We published a paper that showed our transfusion rate was less then 1%.

@mattfoley6082 3 месяца назад

After my aquablation I was kept overnight and my bladder was flushed out with lots of saline until the fluid was mostly clear of blood and clots. I went through 81 liters of saline. Poor nurse was changing a 3 liter bag about every 45 minutes. Flushing helps prevent clogging. I went home day after surgery. Catheter was removed 3 days after surgery. Very little blood in my pee. Pee was all clear after about a week.