Aquablation is a procedure used to treat benign prostate hyperplasia, which means a non-cancerous, enlarged prostate. Aquablation uses a high pressure water jet to remove a portion of the prostate gland. Aquablation may also be used as an added treatment for some patients with prostate cancer to treat urinary retention or a urinary obstruction.

Aquablation is approved by the FDA for the treatment of benign prostate hyperplasia and is usually covered by insurance. Aquablation is proven to be safe and effective and can provide similar or better results than transurethral prostate resection, also called TURP. Most patients (90%) with benign prostate hyperplasia treated with Aquablation experience significant improvement.

Aquablation is performed by doctors called urologists, who specialize in treating diseases and disorders of the urinary system. Urologists have completed medical school, an internship, and a residency in the specialty of urology. Urologists who perform Aquablation therapy work under the supervision of experienced urologists before performing the procedure on their own.

Before undergoing aquablation, patients will be evaluated by an anesthesiologist. An ultrasound will be ordered to provide a clear picture of the area where the urologist will be working. Before the ultrasound, an enema will be given to empty the bowel. Any blood thinners a patient may be taking have to be stopped before the procedure. A urinary catheter will be placed through the urethra into the bladder. The catheter is removed after the procedure.

Aquablation is a short procedure performed under anesthesia in a hospital, and usually takes less than an hour. Aquablation can be used to treat patients with enlarged prostates from 25 to 150 grams. The prostate gland is divided into segments, such as the peripheral and the transition zone, which is located in the middle of the prostate. Benign prostate hyperplasia occurs in the transition zone. Removing 30 to 40 percent of the prostate during aquablation opens up a channel through which urine can flow more freely.

A common complication of aquablation can be bleeding. Some patients with larger prostate glands may be treated with prostate artery embolization before aquablation to decrease the amount of bleeding.

After aquablation, patients may experience some burning pain and some blood in the urine for about two weeks.

After aquablation, patients should avoid heavy lifting and strenuous activities, such as bike and horse riding, or bumpy rides, such as in a golf cart. Patients may resume sexual activity one week after the procedure.

In comparison to transurethral prostate resection, also called TURP, aquablation has a greatly reduced rate (15%) of retrograde ejaculation, which is a complication where the semen goes into the bladder. In contrast, transurethral prostate resection has around a 70% rate of retrograde ejaculation as well as higher rates of erectile dysfunction.

Aquablation is a newer therapy approved to treat benign prostate hyperplasia. Various other therapies are available, such as medical therapy with finasteride and tamsulosin, transurethral prostate resection (TURP), balloon dilation, microwave therapy, needle ablation with radiofrequency, laser therapy, and others. In contrast to those treatments, aquablation offers patients a minimally invasive treatment that is 90% effective, with sustained results. After 10 years, only 10% percent of patients treated with aquablation may need further treatment or surgery.

It is important to ask your doctor how many aquablation procedures they have performed and what their success and failure rates may be. Patients with benign prostate hyperplasia should discuss all treatment options with their doctor.