Medicine relies on technology to improve life expectancy and its quality. Technological advances in medicine – from medical robotics and artificial intelligence to 3D printing and implant design – have managed to simplify processes, obtain earlier and more accurate diagnoses, as well as more positive results in treatments
The use of artificial intelligence and data analysis allow diseases to be detected in their early stages, advances in magnetic resonance technology allow higher quality images to be generated to detect a wide variety of diseases, and surgical robots allow less invasive surgeries to be performed with Greater precision.
New developments in the treatment of urinary symptoms are aimed at treating the problem in a less aggressive way, with minimal hospital admissions and without side effects.
Depending on the size of the prostate, we have different surgical techniques to solve different problems.
Small size prostates (<30cc or high necks)
It is regarding those situations in which there is a small obstructing prostate. This situation can also occur due to obstruction by the bladder neck, which can be high or obstructive.
In these cases, the latest technologies that we have available are iTind, Aqueabeam -although it possibly has more advantages in larger prostates- and the use of the latest versions of the laser. iTind will be the least invasive treatment, although it requires removal of the device 7 days following placement. Its long-term efficacy is unknown, although its short-term results and the absence of side effects are very remarkable. Aqueabeam and the use of Laser would be more conventional strategies, with a surgery time of around 30 minutes and an admission time of less than 1 day.
Medium sized prostates (30-80cc)
In this situation we have many advances. We have very minimally invasive options, such as Rezum or iTind, with minimal surgical times and very short admissions. We can also have the Holmium laser and its latest evolutions, both in haemostasis control and in minimal energy penetration (which translates into less bleeding, shorter admission time and fewer symptoms following the operation). Finally, Aquabeam can be an alternative, being a fast and safe procedure, and with very remarkable results, both in terms of unclogging and in the absence of side effects.
Large prostates (>80cc)
For large prostates we have much fewer alternatives: laser or aquabeam. The advantage of the laser is its great efficacy in the long term, demonstrated in studies with decades of follow-up. However, we know that it presents some complications in the sexual sphere (anejaculation) and other problems related to the technique (urethral stricture, around 5%). The Aqueabeam is a concept of robotic surgery that involves minimal complications. However, its big problem would be the efficacy of the 10-year clearance, which is unknown.
Lastly, and although they are not exactly new in the treatment of benign prostatic hyperplasia, we do want to discuss two technologies that help many men with prostate problems rule out cancer. We are convinced that its use in prostate check-ups will be normalized in the coming years.
The first of these is prostate magnetic resonance imaging (MRI). Nowadays, multiparametric MRI of the prostate is the best option for checking up the prostate when it comes to ruling out the presence of a tumor. Depending on the PSA level and the age of the patient, it is recommended from PSA levels >2.5 in young men to >10 in men over 70 years of age.
Second, genetic tests are a non-invasive way of diagnosing prostate cancer (they have been called liquid biopsy). Despite the fact that they are not yet widespread today, there are several promising genetic tests that may be applied routinely in prostate check-ups in a few years.
At ROC Clinic, Madrid urological clinichave the most cutting-edge tools on the market to offer each man a personalized treatment adapted to his needs.
