Aquablation

Aquablation® is a minimally invasive surgical treatment for an enlarged prostate. Healthcare providers use imaging tests and robotically controlled tools. One of the tools uses a high-pressure water jet to remove prostate tissue.

Aquablation (ah-kwah-BLEY-shuhn) helps treat enlarged prostate symptoms that affect how you pee, like:

• Trouble starting to pee
• A slow or weak pee stream
• Sudden urges to pee
• Waking up more than once to pee

It uses a robotic system that the U.S. Food and Drug Administration (FDA) cleared in 2017. It’s growing in popularity because it:

• Doesn’t require cuts (incisions) or stitches like other enlarged prostate treatments
• Has good long-term results, even if you have a larger prostate
• Has a low rate of complications
• Is the only BPH treatment that uses image guidance during the entire procedure

What happens during Aquablation?

Aquablation usually happens in a hospital setting. You’ll receive general anesthesia — you won’t be awake, move or feel pain during the procedure. Once you’re asleep, healthcare providers will:

1. Insert an ultrasound probe into your rectum and a tube with a camera and light (cystoscope) into your urethra to see your whole prostate
2. Use a high-pressure, heat-free water jet to carefully remove excess prostate tissue
3. Use a suction tool to clear away the excess tissue
4. Seal (cauterize) any exposed blood vessels to stop further bleeding

Aquablation usually takes about an hour. Most people stay in the hospital for one night.

Do you go home with a catheter?

Sometimes. Your provider will insert a Foley catheter into your urethra after Aquablation. The catheter helps:

• Drain pee from your bladder
• Manage bleeding
• Prevent blood clots
• Give your body time to heal

In many cases, providers will remove the catheter the day after the procedure, while you’re still in the hospital. But you may need to use it at home for between a few days and a week. Your provider will give you a better idea of what to expect.

What are the potential benefits and risks?

Aquablation is generally a safe, effective treatment for an enlarged prostate. It has good long-term results. Other benefits include:

• You no longer need to take any medications to treat an enlarged prostate.
• It’s precise. This helps protect areas around your prostate and helps preserve sexual function.
• Recovery is usually faster than more traditional surgeries.

Risks include:

• Bleeding
• Infection
• Problems getting or maintaining an erection
• Semen going into your bladder instead of out of your penis during ejaculation
• Leaking pee
• Needing treatment again if your symptoms return

What is the success rate?

The Aquablation success rate is good. One study shows that less than 1 out of every 25 who get it need additional treatment five years after the procedure.

How long does it take to recover from Aquablation?

As you recover, your enlarged prostate symptoms may get worse before they get better. It’s normal to have blood in your pee, trouble peeing and sudden urges to pee. You should start to see an improvement after a few weeks.

Most people can return to their normal activities a week or two after Aquablation. But it may take longer.

Is there anything I can do to make Aquablation easier on me?

It’s important to give yourself time to allow your body to heal. The following can help make your recovery easier on you:

• Avoid running, heavy lifting, bicycling and other strenuous activities for a few weeks.
• Avoid sexual intercourse and masturbation for at least a few weeks to allow the area to heal.
• Drink lots of water to help flush blood out of your pee.
• Avoid bladder-irritating fluids, including caffeinated or carbonated drinks and citrus fruit juices.

When should I call my healthcare provider?

Your healthcare provider will schedule a follow-up appointment about a week after Aquablation. They’ll remove your catheter and do tests to see how well you pee. They may recommend scheduling additional appointments.

As you recover, call your provider immediately if you experience any of the following:

• Inability to pee
• Discomfort, pain or a burning feeling that gets worse
• Blood clots in your pee, which may look like ketchup
• Signs of infection, including a fever, chills, dizziness or weakness