Aquablation Advantages

February 28, 2023

Aquablation therapy is a one-of-a-kind, advanced, and minimally invasive resective therapy that harnesses the power of water for treating lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia or BPH. Some Aquablation therapy advantages include being safe, effective, long-lasting, heat and incision-free, and ideal for any size or shape prostate with fewer side effects than TURP or some other BPH therapies that employ heat during prostate tissue resection.1,3,4 It represents a paradigm shift in the treatment of BPH symptoms and has been designed for patients and urologists who desire a better treatment option for LUTS due to BPH. Utilizing the AquaBeam robotic system, Aquablation therapy provides the first and only image-guided and heat-free robotically controlled waterjet to treat BPH.

Aquablation therapy was first introduced to the urologic community in 2013 to address benign prostatic hyperplasia and it has been making waves ever since. It can be performed on any prostate, regardless of size or shape, and most men diagnosed with BPH symptoms bothersome enough to warrant additional intervention may be a candidate. Also, a sizeable and increasingly expansive body of clinical evidence supports the benefits of Aquablation therapy.

Why should men compromise when they don’t have to? Some BPH therapies impose limits on prostate size or ask patients to give up something in return for relief. Unfortunately, the “giving up something” typically comes in the form of irreversible complications that can last a lifetime. Aquablation therapy allows the patient to have their cake and eat it too as the adage goes. As a benign prostatic hyperplasia therapy that has fewer side effects, typical BPH surgery trade-offs such as incontinence, ejaculatory dysfunction, or erectile dysfunction are less common with Aquablation therapy.

Science and robotics have made tremendous progress toward developing novel medical therapies over the past few decades. Aquablation therapy is one more success story and is now available to Medicare and other medical plan participants for the treatment of BPH symptoms. The advantages of Aquablation therapy for the treatment of lower urinary tract symptoms are numerous, but here are five important advantages Aquablation affords patients with BPH symptoms.

Robotic Precision

Aquablation therapy utilizes the advanced AquaBeam robotic system to provide the first and only image-guided, heat-free, robotically controlled surgical benign prostatic hyperplasia therapy for the treatment of LUTS. Innovatively precise, the automated robot, together with personalized treatment mapping, combines real-time, multi-dimensional imaging with heat-free waterjet ablation for the precise and rapid removal of obstructive prostate tissue.

Since the procedure is performed via the urethra, no incisions are needed. This minimizes post-operative complications such as severe pain and discomfort and speeds up recovery. Aquablation therapy utilizes heat-free room temperature saline water via the robotically controlled waterjet to ablate excess prostate tissue while avoiding sensitive areas of the prostate, bladder, or urethra that control sexual functionality and continence.

The compromise between safety and efficacy that some alternative BPH procedures require, may be addressed by Aquablation therapy. With its cystoscopic visualization and ultrasound imaging, combined with advanced mapping software and predictability, Aquablation is personalized for each patient based on their unique prostate size, shape, and obstructive characteristics. This results in better decision-making and enhanced monitoring during the procedure.5

Complete View of the Prostate

Combining cystoscopic visualization, ultrasound imaging, and advanced personalized treatment planning software, Aquablation therapy gives the surgeon a multi-dimensional view of the treatment area, unlike any other BPH therapy. Instead of viewing the prostate from a singular perspective as other benign prostatic hyperplasia therapies provide, Aquablation therapy allows the surgeon to visualize the prostate from multiple views and thus render a more precise visual mapping of the prostate and the areas to be removed.

Aquablation therapy’s multidimensional imaging allows for more personalized treatment planning and can address each prostate’s unique anatomy for more precise decision-making and real-time monitoring during the procedure while preserving the anatomy that controls continence and erectile and ejaculatory function. The better the view, the more precise the procedure can be. Aquablation therapy provides the best possible view of the prostate.

No Damaging Resective Heat and Sphincter Preservation

Two major advantages Aquablation therapy offers patients are:

  • A lack of heat during the waterjet tissue removal portion of the procedure which helps preserve important nerves related to proper sexual function.
  • The proper preservation of the sphincter muscle near the bladder neck that is responsible for keeping retrograde ejaculation from occurring.

The AquaBeam robotic system uses a heat-free waterjet to resect only problematic prostate tissue while following a physician’s treatment plan to not resect any prostate, bladder, or urethra tissue that is vital to sexual functionality and continence. Most resective procedures utilize some form of heat to remove prostate tissue, and heat may be damaging to the parts of the prostate that control erectile and ejaculatory function.6

The goal of any prostate procedure in addressing benign prostatic hyperplasia should be to either address the prostate as it is, if possible, or if prostate tissue needs to be removed, to only remove enough prostate tissue without damaging heat or prostate destruction as to bring symptom relief now and well into the future without causing any side effects. In this regard, Aquablation therapy stands alone when addressing large prostate sizes.

Minimal Side Effects

There are many procedures available to men for addressing LUTS brought on by benign prostatic hyperplasia. The optimal BPH procedure for each patient depends upon their health, prostate size, and goals toward addressing their BPH symptoms. Aquablation therapy has minimal side effects compared to other more invasive BPH procedures.1 This includes low rates of irreversible complications such as incontinence, erectile dysfunction, and ejaculatory dysfunction6 Men with any size prostate, but especially those with large prostates over 80cc or grams can greatly benefit from Aquablation therapy’s effectiveness and minimal side effects. As of May 2021, Aquablation has been performed on prostate sizes ranging from 20 to over 500cc with great results.

Some men may not be bothered by the possibility of erectile dysfunction (ED) or retrograde ejaculation (RE) after BPH surgery, but most men would rather not experience those sexual dysfunctions if they have a choice. If minimally invasive BPH surgery is needed or desired, and a man’s prostate isn’t small enough to qualify for office-based BPH procedures or the end goal is different than what a doctor’s office can provide, then Aquablation therapy is a great choice for addressing LUTS brought on by BPH while having a low rate of irreversible complications.1

No surgical treatment is without any side effects. For a listing of potential side effects please visit

Long-Term Relief

Aquablation is one of the newer, more advanced BPH procedures for eliminating LUTS brought on by benign prostatic hyperplasia. Since first being described in 2015 as a BPH procedure that is minimally invasive and robotically assisted, Aquablation therapy has helped men get their lives back on their terms. There aren’t decades of data available that show how long BPH symptoms will remain absent, 5-year data has been published supporting durable results7. All indications so far point to Aquablation therapy being a long-lasting and great alternative to traditional procedures such as TURP for achieving BPH goals while minimizing complications such as retrograde ejaculation.1,2,7,8

If relief from BPH symptoms is needed or desired, Aquablation therapy is a great alternative to traditional BPH surgeries. It provides both immediate and long-term relief from LUTS brought on by BPH. The procedure is FDA cleared and is accepted by Medicare and other major insurance providers.

Watchful waiting only lasts so long for some men. And studies show that medications fail in up to 30% of men within 2 years.9 A precise, reliable, easily performed, durable and long-lasting alternative to watchful waiting and medication was needed that had very little to no side effects or complications.

Aquablation therapy was the answer. Science and technology finally caught up with a man’s desire to cure BPH with a low risk of complications. Aquablation therapy is turning heads as a very effective, minimally-invasive, robotically-controlled, and individually customized BPH procedure for addressing LUTS brought on by benign prostatic hyperplasia or BPH. Additionally, Aquablation therapy’s advantages include being the only treatment for large prostates that offers a low irreversible complication rate.10

If a BPH therapy is desired that gives a man an excellent chance at achieving great results with minimal side effects or complications for any size or shape prostate while achieving their objectives, including preserving continence, erectile function, and antegrade ejaculation, then Aquablation therapy may be worth a serious look.



  1. Nguyen D. et al. WATER vs WATER II Two-Year Comparison of Aquablation Therapy for Benign Prostatic Hyperplasia PD61-01 J. Urol. 2020 May;203(4S)e1280.
  2. Assad A, Nguyen DD, Barber N, Bidair M, Gilling P, Anderson P, Badlani G, Humphreys M, Kaplan S, Kaufman R, So A, Paterson R, Desai M, Roehrborn C, Chughtai B, Zorn KC, Elterman D, Bhojani N. WATER vs WATER II 3-Year Update: Comparing Aquablation Therapy for Benign Prostatic Hyperplasia in 30-80 cc and 80-150 cc Prostates. Urology. 2022 Jul;165:268-274. doi: 10.1016/j.urology.2022.04.004. Epub 2022 Apr 22. PMID: 35469810.
  3. Bhojani N. et al. Aquablation for BPH in Large Prostates (80-150 ml): 1-Year Results. Urology 2019 May; Volume 129.
  4. Pre-specified subgroup analysis larger prostates Gilling P. et al. Three-year outcomes after Aquablation therapy compared to TURP: results from a blinded randomized trial. Can J Urol. 2020 Feb;27(1):10072-10079.
  5. Nguyen D. et al. Operative time comparison of ablation, greenlight PVP, ThuLEP, GreenLEP, and HoLEP. World J of Urol 2020 Feb.
  6. Delay, KJ, et al. Ejaculatory dysfunction in the treatment of lower urinary tract symptoms. Transl Androl Urol. 2016 Aug; 5(4): 450–459.
  7. Gilling PJ et al. Five-year outcomes for Aquablation therapy compared to TURP: results from a double-blind, randomized trial in men with LUTS due to BPH. Can J Urol. 2022 Feb;29(1):10960-10968.
  8. Sadri I, Arezki A, Couture F, Nguyen DD, Schwartz R, Zakaria AS, Elterman D, Rijo E, Misrai V, Bach T, Roehrborn CG, Zorn KC. Reasons to overthrow TURP: bring on Aquablation. World J Urol. 2021 Jul;39(7):2291-2299. doi: 10.1007/s00345-020-03390-x. Epub 2020 Aug 1. PMID: 32740805.
  9. Kaplan, SA. Factors in Predicting Failure with Medical Therapy for BPH. Rev Urol. 2005;7 Suppl 7:S34-9.
  10. Desai M. et al. Aquablation for Benign Prostatic Hyperplasia in Large Prostates (80-150cc): 2-Year Results. Canadian Journal of Urology. 27(2):10147-10153. Apr 2020.

All surgical treatments have inherent and associated side effects. Individual’s outcomes may depend on a number of factors, including but not limited to patient characteristics, disease characteristics and/or surgeon experience. The most common side effects are mild and transient and may include mild pain or difficulty when urinating, discomfort in the pelvis, blood in the urine, inability to empty the bladder or a frequent and/or urgent need to urinate, and bladder or urinary tract infection. Other risks include ejaculatory dysfunction and a low risk of injury to the urethra or rectum where the devices gain access to the body for treatment. Further, there may be other risks as in other urological surgery, such as anesthesia risk or the risk of infection, including the potential transmission of blood borne pathogens. For more information about potential side effects and risks associated with Aquablation therapy for Benign Prostatic Hyperplasia (BPH) treatment, speak with your urologist or surgeon. Prior to using our products, please review the Instructions for Use, Operator’s Manual or User Manual, as applicable, and any accompanying documentation for a complete listing of indications, contraindications, warnings, precautions and potential adverse events. No claim is made that the AquaBeam Robotic System will cure any medical condition, or entirely eliminate the diseased entity. Repeated treatment or alternative therapies may sometimes be required.

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