Aquablation

What is Aquablation?

Aquablation is a minimally invasive, robot-assisted surgical treatment used to relieve urinary symptoms caused by an enlarged prostate, also known as benign prostatic hyperplasia (BPH). BPH is a common condition in ageing men that can make it difficult to pass urine, causing symptoms such as a weak urine stream, frequent urination, urgency, and waking several times during the night to urinate.

Aquablation combines advanced imaging technology with a precise, heat-free waterjet to remove excess prostate tissue that is blocking the flow of urine. During the procedure, the surgeon uses real-time ultrasound imaging to map the prostate and create a customised treatment plan. A high-pressure jet of sterile saline is then used to remove the targeted tissue while preserving surrounding structures whenever possible.

What are the Benefits of Aquablation?

Aquablation offers several advantages for suitable patients seeking long-lasting relief from BPH symptoms, including:

Minimally invasive treatment with no external incisions.
Precise, robot-assisted removal of enlarged prostate tissue.
Heat-free technology that reduces the risk of thermal damage to surrounding tissues.
Effective improvement in urinary flow and bladder emptying.
Lower risk of certain sexual side effects, including preservation of ejaculatory function in many patients.
Suitable for treating a wide range of prostate sizes, including larger prostates.
Short hospital stay, with many patients returning home within 24 hours.
Durable symptom relief and improved quality of life.

When is Aquablation Recommended?

Your urologist may recommend Aquablation if you:

Have moderate to severe urinary symptoms caused by BPH.
Have not achieved adequate relief with medications.
Prefer a minimally invasive alternative to traditional prostate surgery.
Have a larger prostate that may not be suitable for some other minimally invasive procedures.
Experience frequent urinary tract infections, bladder stones, or urinary retention related to prostate enlargement.
Wish to preserve sexual function whenever possible while treating BPH.

What does Preparation for Aquablation Involve?

Before Aquablation, your urologist will perform a comprehensive assessment to determine whether you are a suitable candidate. This may include a physical examination, urine tests, blood tests, prostate imaging, uroflowmetry, cystoscopy, or urodynamic studies. You may also be asked to stop taking blood-thinning medications for a period before surgery if it is medically safe to do so. Your healthcare team will provide fasting instructions and explain what to expect on the day of the procedure.

How is Aquablation Performed?

Aquablation is performed under general or spinal anaesthesia in a hospital operating theatre. Once you are comfortably anaesthetised, the surgeon inserts a specialised instrument through the urethra, eliminating the need for external incisions.

Using real-time ultrasound imaging together with cystoscopic visualisation, the surgeon carefully maps the prostate and identifies the precise areas of tissue causing urinary obstruction. A robotic system assists in planning the treatment, allowing the surgeon to define exactly which tissue should be removed while avoiding important structures whenever possible.

Once the treatment plan has been confirmed, a high-pressure jet of sterile saline is directed at the targeted prostate tissue. The waterjet removes the excess tissue with exceptional precision without generating heat, helping to minimise damage to nearby nerves and tissues. After the tissue has been removed, the surgeon controls any bleeding and places a temporary urinary catheter to aid healing and drainage. The procedure typically takes less than an hour, although the total time in theatre may vary depending on the size of the prostate and individual circumstances.

What to Expect during Recovery after Aquablation?

Most patients remain in hospital overnight, although some may require a slightly longer stay. A urinary catheter is usually removed within one or two days, depending on your recovery. Mild burning during urination, urinary frequency, urgency, or a small amount of blood in the urine is common during the early healing period.

Most people notice a gradual improvement in urinary symptoms over the following weeks, with continued improvement over several months. Your surgeon may recommend avoiding heavy lifting, strenuous exercise, and sexual activity for a short period while the prostate heals. Follow-up appointments help monitor your progress and ensure an optimal recovery.

What are the Risks and Complications of Aquablation?

As with any surgical procedure, Aquablation carries some potential risks, although serious complications are uncommon. These may include:

Temporary blood in the urine.
Urinary tract infection.
Temporary difficulty passing urine after catheter removal.
Bleeding that may occasionally require additional treatment.
Urinary urgency or frequency during healing.
Temporary urinary incontinence.
Narrowing of the urethra (urethral stricture).
Need for further treatment if symptoms recur over time.
Anaesthetic-related risks.