🏥 What is aquablation? Can it improve urinary problems? This article introduces the principles, procedure, differences from traditional surgery, and clinical advantages of aquablation, and how it can improve symptoms of weak urine flow, nocturia, and benign prostatic hyperplasia. It provides professional physician evaluation guidance and recommendations for suitable candidates.

Slower urination, weak urine stream, waking up 2-3 times at night to urinate,” and “needing to strain when urinating”— Many men assume these symptoms are simply an unavoidable part of aging. In reality, you do not have to tolerate this decline in quality of life. As men age, the prostate gland gradually enlarges—a condition commonly known as benign prostatic hyperplasia (BPH). The enlarged prostate can compress the urethra, making urination increasingly difficult. When medication provides limited relief, physicians may recommend further treatment options.

In recent years, Aquablation Therapy has gained significant attention as an advanced treatment choice. This minimally invasive procedure is recognized for its precision, safety, and functional preservation, and has received U.S. FDA approval and CE certification in Europe.

Aquablation uses a robot-assisted, high-pressure cold waterjet to precisely remove excess prostate tissue responsible for urinary obstruction.

Three Core Elements of Aquablation Technology

1️⃣ High-Pressure Waterjet Resection (Hydrodissection)

A high-velocity water stream separates and removes obstructive tissue without the use of lasers or electrocautery, thereby eliminating the risk of thermal injury.

2️⃣ Real-Time Imaging Guidance

Ultrasound imaging is used throughout the procedure, allowing surgeons to clearly visualize prostate anatomy, depth, and critical surrounding structures.

3️⃣ Robotic Control

Robotic assistance enhances surgical precision and consistency, making Aquablation particularly advantageous for patients with large prostate volumes.

👉 Importantly, Aquablation does not remove the entire prostate—it selectively removes only the tissue compressing the urethra.

1. Use of Thermal Energy

Procedure	Thermal Injury Risk
Aquablation	❌ No heat, no thermal damage
TURP (Electrocautery)	✔ Uses heat
Laser Surgery	✔ High thermal energy

Benefits of avoiding thermal energy include:

✔ Reduced risk of nerve injury

✔ Lower incidence of sexual function side effects

✔ Less postoperative irritation and discomfort

2. Prostate Size Suitability

Aquablation is suitable for a wide range of prostate sizes and is especially advantageous for large prostates (approximately 80–150 g or larger).

3. Postoperative Recovery

Aspect	Aquablation	TURP / Laser
Catheter duration	Typically shorter	Moderate
Hospital stay	Usually 1–2 days	2–5 days
Complication risk	Generally lower	Operator-dependent

Large clinical trials, including the WATER and WATER II studies, demonstrate clear benefits of Aquablation:

1. Significant Improvement in Urinary Flow (Qmax)

Most patients experience a noticeable increase in urine flow and smoother voiding.

2. Reduced Nocturia, Frequency, and Urgency

Lower bladder pressure leads to fewer nighttime awakenings and improved daily comfort.

3. Better Preservation of Sexual Function Compared to Traditional Surgery

Because no heat is used:

✔ Lower impact on ejaculatory function

✔ Favorable rates of sexual function preservation

4. Greater Symptom Improvement in Large Prostate Patients

While traditional surgery may be technically challenging for large prostates, ultrasound-guided Aquablation allows for more precise tissue removal.

Patients most likely to benefit include those who:

👉Have limited response to medication

👉 Experience significant urinary symptoms due to BPH

👉 Show markedly reduced urinary flow rates

👉 Have high post-void residual urine and signs of bladder fatigue

👉 Have large prostate volumes (≥80 g)

👉 Wish to reduce risks associated with thermal-based surgery

👉 Hope to preserve sexual function

Final suitability must be determined by a urologist based on ultrasound findings, uroflowmetry, symptom severity, and PSA levels.

Common Recovery Experiences

Recovery varies by individual; follow-up should be conducted according to physician recommendations.

Aquablation integrates real-time imaging, high-pressure waterjet technology, and robotic assistance, offering clear advantages in symptom relief, reduced thermal injury, and functional preservation. Because prostate size, symptom severity, and bladder condition vary among individuals, the most appropriate treatment should always be determined through professional urological evaluation.

Tungs’ MetroHarbor Hospital has achieved JCI international medical quality accreditation, signifying that we meet international medical standards in patient safety, medical procedures, infection control, and quality management, and are continuously subject to rigorous scrutiny. Our urology team combines the experience of professional physicians with precise treatment techniques, and receives cross-border medical assistance from FORMOSA TUNGS+ IMedS International Medical Center. From medical assessment and treatment planning to post-operative follow-up, patients from different countries can clearly understand the process and receive care with peace of mind.