Aquablation: A Minimally Invasive Solution for Enlarged Prostate Symptoms
May 29, 2024

Aquablation: A Minimally Invasive Solution for Enlarged Prostate Symptoms

Texas Health Center for Diagnostics and Surgery

Men dealing with enlarged prostate symptoms now have a minimally invasive option: Aquablation. This advanced procedure offers effective relief for benign prostatic hyperplasia (BPH) with fewer side effects compared to traditional surgeries.

Categories:   Men's Health Urology

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Men living with annoying enlarged prostate symptoms now have a minimally invasive surgical option: Aquablation.

“Aquablation is a newer procedure for benign prostatic hyperplasia, or BPH, which most people know as enlarged prostate,” said Dr. Alex Parker, M.D., a urologist on the medical staff at Texas Health Center for Diagnostics and Surgery (THCDS). “We’ve been using it frequently here at THCDS to treat BPH in a timely manner, and with fewer sexual side effects.”

Aquablation uses high-velocity water-jet technology to remove the tissue blocking the urinary channel. Studies confirm that this surgical strategy usually leads to fewer complications and less time on the operating table compared to traditional surgical methods.1

Anyone struggling with enlarged prostate symptoms is a potential candidate for Aquablation.

“Some of the symptoms we look for are difficulty urinating or waking up frequently at nighttime to urinate,” Dr. Parker said. “If you’re experiencing these problems, likely you’re a good candidate for Aquablation.”

BPH affects many men as they get older — in fact, some 80% of octogenarians have some BPH present. About 25% of men over 50 experiencing symptoms of BPH will require surgery.

“Your prostate can get bigger as you get older, and that can block off the urinary stream and make it difficult to urinate,” Dr. Parker said.

Surgery is generally recommended only after medications have been tried but failed to provide relief.2 Until recently, the “gold standard” treatment for BPH was a procedure called transurethral resection of the prostate, or TURP. TURP is effective in treating BPH, but often leads to complications. Some 53-73% of patients undergoing TURP experienced a side effect called retrograde ejaculation, in which semen enters the bladder instead of emerging through the penis during orgasm.3 Other complications included infection, urethral stricture, bladder neck stenosis and bleeding.

Aquablation represents one of the latest applications of robotic technology in urology.

“We go in with an ultrasound probe, and then we use the Aquablation machine, which is a robotic machine,” Dr. Parker said. “It helps us as surgeons to plan the appropriate treatment course for each patient on an individualized basis. We use water jet therapy to ablate the prostate to open up your urinary channel, so that your symptoms improve.”

Another advantage: Aquablation allows surgeons to perform surgery on very large prostates in a much shorter timeframe. That’s an advantage to the patient, because shorter surgical time is associated with better outcomes.

“We can perform the procedure on very large prostates in the same operative time, so you have less time under anesthesia, which is safer for patients,” said Dr. Parker. “There is no incision through your belly. And with Aquablation, there is a lower risk of sexual side effects compared to the traditional treatments for enlarged prostate.”

Most patients tolerate the Aquablation procedure very well.

“There is usually some discomfort for a few weeks, but that dissipates over time, and most men are doing well by two to four weeks after their surgery,” Dr. Parker said.

Of course, all surgery involves some risk.

“The risks of Aquablation are pretty inherent to most surgeries,” Dr. Parker said.  “There’s a small risk of infection or bleeding, because we will be cutting on you a little bit. But in general, these risks are pretty low. This procedure is very well tolerated for the most part.”

Typically, after undergoing the procedure, patients spend one night in the hospital and then go home with a catheter in place for a few days. The catheter remains in place for less time than is typically required with TURP or other traditional treatments for enlarged prostate.4

“Usually, you come back into the office about three days after surgery,” Parker said. “We take the catheter out, you're able to urinate on your own, and that’s it. You’re able to return to normal life with the symptoms of enlarged prostate eliminated or significantly improved.


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[1] Taktak S, Jones P, Haq A, Rai BP, Somani BK. Aquablation: a novel and minimally invasive surgery for benign prostate enlargement. Ther Adv Urol. 2018 Feb 26;10(6):183-188. doi: 10.1177/1756287218760518. PMID: 29899759; PMCID: PMC5993070.



[4] Review Eur Urol Focus. 2023 Dec 29:S2405-4569(23)00293-6. doi: 10.1016/j.euf.2023.12.001.  “Will Aquablation Be the New Benchmark for Robotic Minimally Invasive Surgical Treatment for Benign Prostatic Hyperplasia?”