New approaches for common urological procedures
Today’s plenary session will demonstrate a new single-incision sling for female incontinence and a saline water-jet ablation for benign prostatic hyperplasia.
Urological surgeons have multiple options to treat female incontinence and benign prostatic hyperplasia. Keeping up with patients’ needs for surgery often can make it difficult to find time to keep up with the latest developments.
“The Annual Meeting has had a special program to help introduce new procedures and devices for several years,” said Gopal Badlani, MD, professor of urology and of obstetrics, gynecology and regenerative medicine at Wake Forest University in Winston-Salem, North Carolina. “We will be focusing on two new approaches in San Antonio: a new single-incision sling for female incontinence and a saline water-jet ablation for BPH. Both of these devices have completed extensive clinical trials, and both of our expert surgeons were part of the trials that led to device approvals.”
Dr. Badlani will introduce these procedures during "How I Do It: Common Urological Procedures" 1:40-2:10 p.m. today in the Stars at Night Ballroom. He was also an investigator on WATER I & II, multicenter, international trials of Aquablation® for BPH.
Today’s semilive session includes two 13-minute surgical videos to demonstrate the new procedures with explanation by the surgeons involved. Following the videos, Dr. Badlani will discuss practical tips for patient selection, patients who should not undergo the procedure, learning curves, short-term and long-term outcomes to date, and ways to work around common complications.
Ricardo Gonzalez, MD, chief of men’s health at Houston Methodist Hospital in Texas, will demonstrate Aquablation, a robotic water-jet resection of the prostate for BPH. The actual ablation procedure takes only three to four minutes, Dr. Badlani noted, although setup can take longer.
A single-use handpiece is inserted into the prostatic urethra and the surgeon uses real-time transrectal ultrasound guidance to define the target resection on a computer console. A high-velocity robotic water-jet removes the target tissue.
Because the device is inserted via the urethra, the procedure is far less morbid than open BPH surgery. It is also far less expensive than conventional robotic surgery with a shorter learning curve compared to other laser devices.
Catherine Matthews, MD, professor of urogynecology and pelvic reconstructive surgery at Wake Forest School of Medicine, will demonstrate the Altis® single-incision sling for female incontinence. Dr. Matthews was principal investigator in a study comparing the single-incision device to a standard midurethral transobturator or retropubic slings.
The new device offers simpler, faster surgery than other slings, Dr. Badlani said. Even though the device is too new to have long-term data, a recent multicenter trial showed high efficacy over the first year.
“These are procedures that can be performed by a general urologist in community practice,” Dr. Badlani said. “Our goals are to make general urologists aware that these procedures are available to them, that the techniques have short learning curves and that they can easily add these approaches to their practices. This session is all about knowledge transfer to build a urologist’s ability to help their patients.”
