Urologist discusses Aquablation, rise in large prostates seen in his practice

Opinion
Video

"I'd be curious to see a validated study on whether prostate sizes have increased over time. I suspect the answer will be yes," says Joseph Song, MD.

In this video, Joseph Song, MD, discusses Aquablation and shares an observation regarding an increase in large prostates. Song is a urologist with Georgia Urology.

Transcription:

There are multiple procedures out now where patients don't necessarily need to even be under full anesthesia. Certainly, that's led to faster recovery, less invasive techniques, patients who have less side effects. The new Aquablation procedure in particular has been really interesting how it's changed what we do. Because if you think about previously, if you were going to do a TURP, there would be an upper limit on what you could resect, and most urologists put that around at 80 to 100 g, right? With something like an Aquablation, we're tackling bigger and bigger glands. And as a result, we're still able to treat men who have very large prostates, but don't need to make incisions don't need to go in and do a simple prostatectomy. We can treat it more endoscopically. But what I've run into is some of these glands are so large, that sometimes you get this median lobe that's all the way into the bladder, several centimeters into the bladder, to the point where you're perhaps triggering an obturator reflex. And that's something you would never see if you're doing a TURP on an 80- or 100-g prostate. So we're kind of getting into this new realm where we're doing endoscopic management for such big glands that it's a very different surgical experience. What's more is I personally feel like the size of prostates has increased dramatically. Anecdotally, in residency, if we saw a 75, 80, 100-g prostate, we thought, that's a really big prostate gland. Now, I see those on a weekly basis. I don't know if it has something to do with diet or that now I'm in Atlanta; before, I was in St. Louis, whether it's just population. I'd be interested to see if the average size of prostates have grown, because we see so much more. I know that kind of diverges from your question, but it's just an interesting observation that I've had. I'd be curious to see a validated study on whether prostate sizes have increased over time. I suspect the answer will be yes.

This transcription has been edited for clarity.

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