Health Matters: What is Aquablation therapy?

Dr. Kevin Brown

December 16, 2022

Benign Prostatic Hyperplasia (BPH), or the enlargement of the prostate, is a common urologic condition that affects men as they age. BPH can cause a variety of symptoms including problems with urination such as difficulty starting or stopping the flow, weak stream and frequent urination. Treatment options for BPH include medications, minimally invasive procedures and traditional surgery. Aquablation therapy is a relatively new treatment option for BPH that is gaining more attention as an alternative to traditional treatments.

When to consider treatments beyond medication for BPH?

Medications can help treat BPH, but even medication therapy can fail to resolve symptoms for one in three men by five years. Additionally, many men experience side effects or intolerance to medications, which increases the rate of failure when treating BPH. Medication therapy may not be effective for people whose symptoms have already progressed to the moderate or severe stage.

The point at which one decides it's time to consider other treatment options for BPH depends on the individual, but it’s important to know that there are safe and effective treatments for BPH. Many men try to delay surgery for their BPH due to concerns of complications or side effects, such as concerns that surgery will affect sexual function and urinary continence. Surgical treatments such as Aquablation therapy allows for precise prostate tissue removal, minimizing the risks of these side effects and making it a safe and effective treatment option for most men.

What is Aquablation therapy and how does it compare to other treatment options?

Aquablation therapy is one of several surgical treatments available to treat BPH. Using ultrasound imaging, a surgical map is created outlining which parts of the prostate should be removed and which parts to avoid. A provider and robotically-controlled, heat-free waterjet is then used to remove the prostate tissue outlined in the map, preserving the area of the prostate involved in sexual function and urinary incontinence. Because the procedure is performed through the urethra, there are no incisions, and recovery is quick and often fairly painless.

Other surgical therapies outside of Aquablation can destroy or harm this delicate tissue by using heat or harsh substances, likely contributing to some of the sexual dysfunction seen after those procedures. Because Aquablation uses room temperature water, the tissue is removed and the blockage is fixed without harming or burning the remaining prostate tissue. The risk of sexual dysfunction after Aquablation is only around 10%, compared to a 30-100% risk with some other surgical approaches.

The Aquablation procedure is performed under anesthesia in an operating room and typically takes about 45 minutes, almost half as long as traditional techniques.

How would I know if Aquablation is right for me?

First, we encourage you to speak with your provider. They can help you understand your symptom severity and effectively weigh your options.  Aquablation therapy may be the better option for you if:

  • Your BPH symptoms are moderate to severe.
  • Your medications are failing.
  • You can no longer urinate on your own and have to use a catheter.
  • Your prostate is very enlarged.
  • You're experiencing other complications of BPH, including kidney failure, infections, bleeding and stones.

How long does it take to recover from Aquablation therapy?

After Aquablation therapy, the majority of men need just a one night stay in the hospital for monitoring and use of a catheter. The catheter is typically removed the next morning and the majority of men go home catheter free. There is little discomfort after the procedure and most men report no pain only a few days after the surgery. The main restriction is to not lift more than ten pounds in each arm for two weeks, to reduce the risk of bleeding as the prostate heals.

Aquablation is a remarkably effective procedure. When we take a look at men five years post-surgery, 95% of them still see lasting results. It's a durable treatment option for men with BPH that has the lowest risk of sexual side effects compared to traditional prostate surgeries.

Dr. Kevin Brown is a Urologist located at St. Peter’s Health Medical Group Broadway Clinic.