Since being first introduced to the urologic community in 2013, Aquablation Therapy has been a source of relief for men suffering from lower urinary tract symptoms (LUTS) brought on by benign prostatic hyperplasia or BPH. Developed by PROCEPT BioRobotics, the Aquablation therapy procedure is an FDA-cleared, innovative, and transformative resective therapy that utilizes the AquaBeam Robotic System and the power of a high-velocity waterjet to remove excess prostate tissue. Aquablation Therapy is the only BPH treatment that utilizes a waterjet to address an enlarged prostate while preserving continence and sexual functionality. The goal of Aquablation Therapy is to provide men who are diagnosed with BPH, and who want to address their LUTS, an alternative to traditional, more invasive prostate surgeries that may result more frequently in irreversible complications and ejaculatory dysfunction.
This patient question and answer guide should help answer ten of the more popular questions about Aquablation Therapy and how the procedure can help men with any size or shaped prostate address their benign prostatic hyperplasia. Utilizing robotic precision, and facilitated by PROCEPT BioRobotics’ AquaBeam Robotic System in harnessing the power of water to decrease prostate size, Aquablation Therapy is a life-changing BPH treatment that can positively change a man’s outlook and allow him to get back to the things he enjoys without BPH dictating the terms.
Aquablation Therapy Questions and Answers
How Does Aquablation Therapy Work? Through the use of a custom-tailored (for each man) surgical map/plan and quick, cutting-edge water resection of the prostate without any incisions via a heat-free robotically controlled waterjet, Aquablation therapy precisely eliminates excess obstructive prostate tissue through the urethra to greatly improve LUTS brought on by benign prostatic hyperplasia and without damaging vital male anatomy that controls critical sexual and urinary function. Aquablation therapy is the only BPH procedure that gives the surgeon the advantage of viewing the entire prostate multidimensionally and in real-time through the use of both a camera-aided cystoscope and ultrasound imaging. Aquablation therapy is a hospital-based procedure, and it is performed under either general or spinal anesthesia.
How Long Does the Aquablation Therapy Procedure Take? The Aquablation therapy procedure typically takes less than an hour to perform from start to finish, including creating the digital surgical map and the waterjet resection (removal) of excess problematic prostate tissue. Patients can expect to spend the night in the hospital and will be fitted post-procedure with a catheter which allows for urination while the urethra heals from the procedure.
What are the Benefits of Aquablation Therapy? There are many benefits for a man who undergoes Aquablation therapy, but probably the most important benefit is that he gets to address his BPH symptoms on his terms without having to sacrifice important aspects of his sexuality.2,4 Some of the benefits of Aquablation therapy include:
- Accommodation of any size or shaped prostate from 30 to over 200 grams or mL2,4
- Digital mapping of the prostate before the resective phase of the surgery
- Real-time imaging via ultrasound and cystoscopy
- Robotic precision
- Heat-free waterjet resection
- Incision-free
- Sphincter preservation
- Ejaculatory preservation2,4
- Substantial debulking of prostate tissue2,4
- Minimal common side effects2,4
- Long-lasting relief2,4
- Urinary and sexual functions maintained2,4
What are the Potential Side Effects of Aquablation Therapy? Another benefit of Aquablation therapy for treating benign prostatic hyperplasia is it features very few side effects on average, which are typically mild and temporary, however men considering Aquablation therapy should review all potential risks with their urologist in evaluating whether the treatment may be right for them. Some side effects can include:
- Mild burning during urination
- Bleeding while urinating
- Straining while urinating
- Pelvic discomfort
- Inability to empty the bladder
- Frequent urination
- Urgent need to urinate
- Bladder infection
- Urinary tract infection
- Ejaculatory dysfunction
- Injury to the urethra
- Injury to the rectum
- Anesthesia risk
For a complete list of potential side effects, please visit https://aquablation.com/safety-information/
How Long Does It Take to Recover from Aquablation Surgery? While a patient will wake up from the procedure with a catheter in place, this is so the urethra has a chance to heal overnight in the hospital. Before being discharged, the catheter may be removed to see if urination is possible without the catheter. If not, the patient will typically be sent home with a catheter or an additional night in the hospital may be recommended. Apart from a few days with a catheter, there may be mild burning for a week or two when urinating. This can be easily controlled with typical pain medication.
What is the Recovery Process Like After Aquablation Therapy? After arriving back home, there may be discomfort for a few weeks while urinating, but normal activities should be able to be resumed shortly and after consultation and approval from the attending physician.
What are the Expected Outcomes of Aquablation Therapy? A man who undergoes Aquablation therapy to address benign prostatic hyperplasia can expect significant improvement in their LUTS symptoms. Aquablation therapy patients can typically enjoy a much stronger urine stream, less frequent trips to the restroom, better bladder control at night, and the luxury of not having to have a bathroom at arm’s length everywhere they go. Frequency and urgency can typically be addressed with Aquablation therapy, along with starting and stopping, dribbling, incomplete emptying, and other bothersome LUTS symptoms.5
Can Aquablation Therapy be Repeated if Needed? The short answer is yes. However, the need for a repeat procedure appears to be remote. Aquablation therapy has developed a track record of being a durable procedure. “The urological community has been waiting to see if the early, pronounced benefits from Aquablation would remain over time. With the 5-year data from two study’s now available, the Aquablation results are quite durable and look to have a very low rate of men needing additional treatment. Given the broader range of prostate size and anatomy Aquablation can treat, this technology has the potential to change the paradigm of how BPH is treated,” said Dr. Alexis E. Te1, Mount Sinai Medical Center.2
What are the Chances of your Prostate Problem Returning after Aquablation Therapy? Since the prostate continues to grow throughout most of a man’s life, LUTS caused by benign prostatic hyperplasia could re-occur if the prostate re-grows in a direction that again impacts the urethra or bladder. As with any BPH procedure, there is a small risk that LUTS could return at some point in time after receiving treatment.5
What are the Contraindications for Aquablation Therapy? Aquablation therapy is contraindicated in the presence of active infection or not being able to stop anticoagulant medications. Patient should consult their urologists for specific contraindications outside the United States.
In Conclusion
Many questions are being asked about Aquablation therapy since it is increasingly helping more men who suffer from LUTS brought on by BPH. With Aquablation therapy’s ability to handle any size or shaped prostate, its incision and heat-free resection, and its low risk of sexual side effects such as ejaculatory dysfunction, it is getting a lot more attention from men who want to address benign prostatic hyperplasia.
Content in this blog is for informational purposes only and does not constitute medical advice and should not be used for medical diagnoses. PROCEPT BioRobotics recommends that you consult with your physician on all matters pertaining to your health or to address any clinical/medical questions.
References:
- Alexis E. Te was a study site principal investigator for the WATER study and consultant to PROCEPT BioRobotics.
- 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.
- https://reports.mountsinai.org/article/uro2022-05-aquablation-is-proving-to-be-innovative-and-successful
- Bhojani N et al. Aquablation Therapy in Large Prostates (80-150 mL) for Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia: Final WATER II 5-Year Clinical Trial Results. J Urol. 2023 Jul.
- Elterman D et al. Meta-analysis with individual data of functional outcomes following Aquablation for lower urinary tract symptoms due to BPH in various prostate anatomies. BMJ Surg Interv Health Technologies. 2021 Jun.