Waking four or five times every night to pass urine, planning journeys around toilet stops or worrying about getting through a meeting or social occasion without urgently needing the bathroom can quietly take over daily life.
Many men assume these symptoms are simply part of ageing. In reality, they are often caused by an enlarged prostate, a common condition known as benign prostatic hyperplasia (BPH).
As a Consultant Urologist, I frequently see men who have adapted their routines around urinary symptoms for years before seeking help. Long waiting times can also mean symptoms persist longer than they should. Today, advanced diagnostics and modern prostate enlargement treatments allow us to investigate symptoms thoroughly and offer effective solutions tailored to everyone.
One of the most significant developments in BPH treatment options in recent years is Aquablation therapy, a precise, robotically assisted procedure designed to improve urinary symptoms while protecting quality of life.
What Is Aquablation Therapy for Enlarged Prostate?
Aquablation therapy is a minimally invasive surgical treatment for benign prostatic hyperplasia (BPH).
It uses real-time ultrasound imaging and robotic technology to guide a high-pressure jet of sterile water that removes prostate tissue blocking urine flow.
Unlike traditional surgery, treatment is carefully planned before tissue removal begins. This allows the procedure to be tailored to each patient’s anatomy with the aim of relieving obstruction while protecting surrounding structures involved in continence and sexual function.
When Should You Consider Prostate Enlargement Treatment?
Many men live with prostate symptoms for several years before seeking specialist advice. Some reduce fluid intake, avoid travel or wake repeatedly overnight without realising effective treatments are available. Common symptoms include:
- Weak or slow urine flow
- Difficulty starting urination
- Frequent daytime or night-time urination
- Urgency or leakage
- Feeling the bladder does not empty fully
Medication is often the first step. Your doctor will always start with the most minimally invasive option. However, surgery may be recommended when medication is ineffective or causes side effects, symptoms continue to affect quality of life or complications such as urinary retention develop. A detailed assessment helps determine which BPH treatment options are most suitable.
How Is Aquablation Therapy Different From TURP or Laser Surgery?
Traditional prostate surgery such as Transurethral Resection of the Prostate (TURP) or laser procedures removes tissue using electrical energy or heat. While effective, these techniques rely heavily on manual surgical judgement during the operation and can cause thermal injury to surrounding tissue.
Aquablation therapy uses imaging to map the prostate before treatment begins. A robotic system then removes only the planned tissue using a water jet rather than heat. Because of this approach, Aquablation may offer:
- Consistent treatment regardless of prostate size
- Reduced risk of certain sexual side effects
- Less heat-related tissue damage
TURP surgery has been the standard treatment for many years, but can involve a longer recovery period for some patients and recognised risks such as bleeding or ejaculatory dysfunction. Newer techniques such as Aquablation aim to provide effective symptom relief, while reducing these risks.
Assessment Before Aquablation Therapy
Understanding symptoms properly is essential before recommending surgery. A consultation focuses not only on medical history, but also how symptoms affect sleep, confidence, work and daily routines.
Assessment may include urine flow testing, ultrasound or MRI imaging, PSA blood testing, prostate size measurement, flexible cystoscopy to examine the bladder directly. These investigations help confirm diagnosis and ensure Aquablation therapy is the right treatment choice.
Aquablation Therapy Procedure Explained
Aquablation therapy is performed under anaesthetic in hospital without external incisions. A camera device is introduced through the urethra and ultrasound imaging allows the prostate to be visualised clearly. A personalised treatment map is created before tissue removal begins.
A robotic system then delivers a precisely controlled water jet to remove obstructing tissue according to this plan.
The procedure typically takes around 45minutes and most patients remain in hospital overnight with a temporary catheter. The procedure can be completed as a day case.
Aquablation Therapy Success Rate and Recovery
Clinical studies demonstrate significant improvements in long-term urinary symptoms following Aquablation therapy. Patients commonly describe stronger urine flow , improved bladder emptying and better sleep due to fewer night-time toilet visits.
A large double-blind randomised clinical trial comparing Aquablation with TURP found significantly lower rates of procedure-related ejaculatory dysfunction and a 51% lower likelihood of requiring further BPH treatment following Aquablation, (*1 Gilling et al., 2022).
Why Aquablation Therapy Is Becoming a Leading BPH Treatment Option
There are several prostate enlargement treatment options available, but Aquablation therapy combines robotic precision with individualised planning. Potential advantages include:
- Effective treatment even in larger prostates
- Preservation of continence mechanisms
- Reduced risk of certain sexual side effects
- Consistent results supported by imaging guidance
Treatment decisions are always personalised. The most suitable option depends on symptoms, anatomy, and individual priorities. All of which, would be discussed in detail in your assessment and following diagnostics.
What to Expect After Aquablation Therapy
Most patients return home once the catheter has been removed and urine flow is comfortable. Temporary side effects such as blood in the urine or increased urgency during healing are common early on and expected as healing occurs but usually settles as recovery progresses.
Gentle activity can resume quickly, although heavy lifting should be avoided initially. Clear aftercare advice and follow-up appointments help ensure the best long-term outcomes.
If you are experiencing urological symptoms and would like an assessment, or if you have already received a diagnosis and would like to explore whether Aquablation therapy may be the right treatment for you, please get in touch to discuss your options or book an appointment.
