Aquablation Therapy for BPH (Enlarged Prostate): Benefits, Procedure & Recovery

About Aquablation Therapy

Aquablation therapy is a minimally invasive treatment for urinary symptoms caused by benign prostatic hyperplasia (BPH), also known as an enlarged prostate. 

It uses a robotically controlled, heat-free waterjet and real-time ultrasound imaging to remove excess prostate tissue while helping preserve sexual function and urinary continence.

Key Benefits of Aquablation Therapy for BPH

Aquablation therapy offers several advantages for men seeking treatment for an enlarged prostate:

  • Minimally invasive treatment for BPH
  • Robotically assisted, heat-free waterjet technology
  • Real-time ultrasound guidance for personalized treatment planning
  • No abdominal incision required
  • Designed to help preserve erectile function, ejaculatory function, and urinary continence
  • Effective across a wide range of prostate sizes and shapes

How Aquablation Therapy Works 

  • Aquablation therapy removes enlarged prostate tissue through the urethra, so no abdominal incision is required.  
  • The procedure is performed in a hospital under anesthesia and typically takes about one hour. Some patients may stay overnight.

Key Steps in  Aquablation Therapy for Treatment of BPH 

Treatment consists of two main steps that happen one after the other while you are asleep under general anesthesia.

  • Step 1: Personalized Treatment Planning 
    • Every prostate is unique in size and shape. Aquablation therapy enables our surgeons to customize your procedure to your specific anatomy.
    • Using a combination of real-time ultrasound imaging and digital cystoscopy, your surgeon creates a customized treatment map based on your anatomy.
    • This planning process helps identify prostate tissue to remove while preserving important surrounding structures whenever possible.
    • The detailed visualization allows your surgeon to determine which areas to treat and which areas to avoid. This helps to support the following functionality after the procedure: erectile function, ejaculatory function, and urinary continence.
  • Step 2: Targeted Tissue Removal 
    • Once your surgeon creates the treatment map, a robotic-assisted, heat-free waterjet follows the surgeon-defined plan to remove obstructive prostate tissue.
    • This technology is designed to deliver precise and predictable tissue removal across a wide range of prostate sizes and shapes.
    • If needed, a small amount of cautery may be used after the procedure to control bleeding.

Benefits of Aquablation Therapy

Many patients choose Aquablation therapy because it combines advanced imaging with robotic precision.

Potential benefits:

  • Personalized treatment based on your anatomy
  • Real-time ultrasound guidance throughout the procedure
  • Heat-free tissue removal
  • Low rates of irreversible complications reported in clinical studies
  • Durable symptom relief for many patients
  • Long-term relief from enlarged prostate symptoms

Aquablation Allows Personalized Treatment Planning

Aquablation therapy combines real-time imaging with robotic-assisted execution to create a treatment plan tailored to each patient's anatomy.

Long-Term Symptom Relief

Clinical studies1,2 have shown durable symptom improvement through five years following treatment.
Patients may experience these symptom improvements:

  • Frequent urination
  • Urinary urgency
  • Weak urine stream
  • Difficulty emptying the bladder
  • Nighttime urination (nocturia)

Recovery After Aquablation Therapy

Most patients navigate four key recovery phases:

  1. Wake up with a temporary urinary catheter
  2. Stay in the hospital overnight
  3. Have the catheter removed before going home
  4. Return home the following day

During recovery, patients may experience these temporary symptoms:

  • Mild burning with urination
  • Increased urinary urgency
  • Increased urinary frequency

These symptoms are typically temporary and can often be managed with medication recommended by your physician.

Patients may resume normal activities once approved by their doctor.

Follow-Up Care After Aquablation Therapy

Follow all discharge instructions provided by your surgeon and contact your health care team if you have questions during recovery.

Is Aquablation Therapy Right for You?

If you are experiencing symptoms of BPH or enlarged prostate, talk with your urologist to determine whether Aquablation therapy may be right for you.

Aquablation therapy is generally intended for men with benign prostatic hyperplasia (BPH), also known as an enlarged prostate, who have bothersome urinary symptoms that affect quality of life.

For a healthy man in his 60s or 70s, a practical expectation is often a few days to feel reasonably well, one to two weeks to resume many normal activities and several weeks for urinary symptoms to stabilize and reach their best improvement.

Compared with TURP, these are the key differences with Aquablation:

  • Uses a heat-free water jet rather than electric cutting or cautery.
  • Can treat larger prostates.
  • May have a lower risk of ejaculatory dysfunction.
  • Typically provides significant improvement in urinary symptoms.
     

Yes. One of the main advantages of Aquablation is that it is designed to better preserve sexual function, particularly ejaculation, compared with some traditional BPH surgeries. The procedure uses real-time ultrasound guidance and a heat-free water jet, allowing the surgeon to avoid critical structures involved in sexual function.

Aquablation can be used for a wide range of prostate sizes, including larger prostates that may be more challenging to treat with some other minimally invasive procedures. It uses real-time ultrasound guidance and a robotically controlled water jet to remove excess prostate tissue while helping preserve surrounding structures.

Before Aquablation begins, the surgeon creates a detailed, personalized map of the prostate using a combination of real-time ultrasound imaging and direct visualization with a cystoscope (a small camera inserted through the urethra). This mapping allows the surgeon to identify exactly which tissue should be removed and which structures should be preserved. 

In simple terms, the surgeon creates a custom surgical blueprint of your prostate before any tissue is removed, and the AquaBeam system then carries out that plan with robotic precision.

Yes. Most patients will have a urinary catheter after Aquablation. The catheter helps drain urine and allows the bladder to be irrigated to clear blood and debris from the treated prostate area during the initial recovery period.

The duration varies based on these variables:

  • The size of your prostate
  • How much bleeding occurs after the procedure
  • How well you're able to urinate on your own
  • Your surgeon's protocol

This is the typical patient experience:

  • The catheter is removed within 24 hours, often the next day.
  • Some patients may go home with the catheter and return a few days later for removal if additional healing time is needed. 
  • Men with very large prostates or significant postoperative swelling may need it for a longer period.
     

Yes. While Aquablation is suitable for many men with BPH, there are situations where it may not be the best choice or may require careful evaluation first. 

It may not be the best course of action for men with these conditions:

  • Active urinary tract infection
  • Certain bleeding disorders
  • Severe kidney disease or serious medical illness
  • Previous prostate treatments
     

Some combination of the following may be prescribed or recommended by your urologist:

  • Pain relievers such as acetaminophen (Tylenol). Some patients may receive a short course of stronger pain medication if needed. 
  • Bladder spasm medications if you experience cramping or urgency caused by the catheter or bladder irritation.
  • Anti-inflammatory medications, depending on your medical history and your surgeon's preference.
  • Antibiotics, either around the time of surgery or afterward if your physician believes they're necessary to reduce infection risk. 
  • Sometimes medications already used for BPH, such as alpha blockers, may be continued temporarily during recovery.
     

Your urologist will typically monitor recovery through a combination of symptom assessment, urine function checks, catheter management and follow-up visits. The goal is to ensure you're healing properly, urinating well and seeing expected improvement in BPH symptoms.

REFERENCES

  1. Gilling PJ, et al. Can J Urol. 2022
  2. Bhojani N, et al. J Urol. 2023