Aquablation Therapy

Aquablation Therapy is an innovative, minimally invasive treatment for benign prostatic hyperplasia (BPH) – a condition where the prostate gland enlarges and causes urinary difficulties. Unlike traditional surgical treatments, Aquablation Therapy uses high-velocity water jets controlled by robotic precision to remove excess prostate tissue while preserving surrounding structures.

This procedure is gaining popularity due to its ability to offer effective symptom relief with a lower risk of side effects such as incontinence and sexual dysfunction. It is particularly beneficial for men with moderate to severe BPH who have not responded well to medication.

In this guide, we’ll explore how Aquablation Therapy works, why it is performed, what to expect during recovery, and potential risks.

Why is Aquablation Therapy Performed?

Aquablation Therapy is primarily used to treat benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate gland that can cause significant urinary symptoms. As the prostate grows, it can compress the urethra, leading to difficulties with urination.

Common symptoms of BPH

Men with BPH may experience:

• Frequent urination, especially at night (nocturia)
• Weak or interrupted urine flow
• Difficulty starting urination (hesitancy)
• A feeling of incomplete bladder emptying
• Urgency or inability to delay urination
• Increased risk of urinary tract infections (UTIs)

Who is Aquablation Therapy suitable for?

This treatment is particularly beneficial for men who:

• Have moderate to severe BPH symptoms affecting their quality of life
• Have not responded well to medications such as alpha-blockers or 5-alpha reductase inhibitors
• Have a larger prostate (over 80-100 grams), where other procedures like TURP (transurethral resection of the prostate) may be less effective
• Want a lower risk of side effects such as erectile dysfunction or incontinence

What happens if BPH is left untreated?

If BPH is not managed, it can lead to progressive urinary retention, an increased risk of bladder stones, urinary tract infections, and in severe cases, kidney damage. Aquablation Therapy provides long-term symptom relief while preserving normal urinary and sexual function.

How is Aquablation Therapy performed?

Aquablation Therapy is a robotically controlled, minimally invasive procedure that removes excess prostate tissue using a high-velocity saline water jet. The procedure is performed in a hospital under anaesthesia and typically takes less than an hour.

1. Pre-surgery preparation

Before the procedure, patients may need:

• A preoperative assessment, including urine tests, blood tests, and imaging (such as an ultrasound or MRI) to evaluate prostate size.
• Temporary discontinuation of certain blood-thinning medications to reduce bleeding risk.
• Fasting for several hours before surgery, as advised by the medical team.

2. During the procedure

Aquablation Therapy is performed using the AquaBeam® Robotic System, which combines ultrasound imaging and robotic precision to guide the treatment. The key steps include:

• Anaesthesia: The patient is given general or spinal anaesthesia to ensure comfort.
• Real-time prostate mapping: The surgeon uses ultrasound imaging to create a detailed 3D map of the prostate.
• Waterjet ablation: A high-velocity saline waterjet removes the overgrown prostate tissue without using heat, reducing the risk of damage to surrounding nerves and structures.
• Automatic precision control – The robotic system ensures that only the targeted tissue is removed, preserving key areas related to urinary and sexual function.

3. Post-procedure care

• A temporary catheter is placed in the bladder to help drain urine while the prostate heals.
• The patient is monitored for a short period and typically stays in the hospital for one night before being discharged.

Recovery & rehabilitation from Aquablation Therapy

Aquablation Therapy offers a quicker recovery time compared to traditional prostate surgeries. Most patients can expect to resume normal activities within a few days to weeks, with full recovery taking a few months.

1. Immediate post-procedure recovery

• Patients typically stay in the hospital for one night for monitoring.
• A urinary catheter is placed to help with bladder drainage. This is usually removed within a few days but may be needed longer for some patients.
• Some mild bleeding in the urine (haematuria) is normal and usually resolves within one to two weeks.

2. At-home recovery

• Hydration: Drinking plenty of water helps flush out the bladder and promote healing.
• Activity: Light activities can be resumed within a few days, but strenuous exercise should be avoided for at least two weeks.
• Medications: Patients may be prescribed pain relievers or antibiotics to prevent infection.
• Urinary Symptoms: Temporary urinary urgency, frequency, or mild discomfort may occur but usually improve within a few weeks.

3. Long-term recovery

• Most men experience significant relief from BPH symptoms within three to six months as the prostate fully heals.
• Unlike heat-based procedures, Aquablation Therapy has a lower risk of sexual dysfunction and incontinence.
• Regular follow-up appointments with a urologist ensure proper recovery and monitor urinary function.

Risks & potential complications

Aquablation Therapy is considered a safe and effective procedure for treating BPH, with a lower risk of long-term complications compared to traditional prostate surgeries. However, as with any medical procedure, there are potential risks to consider.

1. Common Side Effects

These are typically mild and temporary, resolving within a few weeks:

• Blood in the urine (haematuria): Some mild bleeding is expected and usually clears up within one to two weeks.
• Urinary urgency or frequency: Temporary irritation may cause increased urination, but this usually improves as healing progresses.
• Mild discomfort or burning during urination: This is common in the first few days and can be managed with hydration and medications.

2. Less common but possible complications

While rare, some patients may experience:

• Urinary retention: Difficulty urinating may require a longer catheter use until the bladder function normalises.
• Urinary tract infection (UTI): The use of a catheter can slightly increase the risk of infection, which may require antibiotic treatment.
• Temporary loss of ejaculation (retrograde ejaculation): Some men may experience changes in ejaculation, but the risk is lower than with traditional BPH surgeries.
• Mild bleeding requiring intervention: In rare cases, additional treatment may be needed to manage persistent bleeding.

3. How risks are managed

• The robotic precision of the Aquablation system helps preserve important structures, reducing the risk of incontinence and erectile dysfunction.
• Patients are closely monitored after surgery, with follow-up visits to track recovery and address any concerns.
• If complications arise, they are usually treatable with medications or minor interventions.

Overall, Aquablation Therapy provides effective symptom relief with a strong safety profile, making it a preferred option for many men with BPH.

How long does Aquablation Therapy take?

The procedure itself usually takes less than an hour, with the actual waterjet treatment lasting only a few minutes. However, patients should expect to spend a few hours at the hospital for preparation, monitoring, and recovery. Most patients stay overnight for observation and are discharged the next day.

How painful is Aquablation Therapy?

Aquablation Therapy is performed under general or spinal anaesthesia, so patients do not feel pain during the procedure. After surgery, some men may experience mild discomfort, urinary urgency, or a burning sensation while urinating, but these symptoms typically subside within a few days to weeks.

Aquablation vs Rezūm

The main difference between Aquablation and Rezūm is the method of tissue removal for treating benign prostatic hyperplasia (BPH). Aquablation uses high-pressure water jets under robotic control, while Rezūm uses steam to ablate prostate tissue. Aquablation offers more precision; Rezūm is less invasive and typically done in-office.

Aquablation vs GreenLight laser therapy

The main difference between Aquablation and GreenLight laser therapy is the technology used to remove prostate tissue. Aquablation uses high-pressure water jets guided by robotic imaging, while GreenLight laser vaporizes tissue using a high-energy laser. Aquablation provides more anatomical precision; GreenLight offers quicker recovery with less bleeding.

Aquablation vs HoLEP

The main difference between Aquablation and HoLEP is how prostate tissue is removed. Aquablation uses high-pressure water jets with robotic guidance, while HoLEP (Holmium Laser Enucleation of the Prostate) uses a laser to cut and remove tissue endoscopically. Aquablation offers faster recovery; HoLEP removes larger volumes of tissue.

Aquablation vs PAE (Prostatic Artery Embolization)

The main difference between Aquablation and PAE (Prostatic Artery Embolization) is the treatment approach. Aquablation uses robotic-controlled water jets to remove prostate tissue, while PAE shrinks the prostate by blocking blood flow through embolization. Aquablation physically removes tissue; PAE reduces size without cutting or heat.

Aquablation vs UroLift

The main difference between Aquablation and UroLift is the method of symptom relief. Aquablation removes prostate tissue using robotic-controlled water jets, while UroLift lifts and holds the enlarged prostate tissue away from the urethra using implants. Aquablation is more invasive; UroLift preserves sexual function with minimal downtime.

Aquablation vs TURP

The main difference between Aquablation and TURP (Transurethral Resection of the Prostate) is the technique for tissue removal. Aquablation uses image-guided water jets controlled by robotics, while TURP uses a heated wire loop to cut away prostate tissue. Aquablation reduces heat-related side effects; TURP is the traditional gold standard.