Aquablation therapy uses a high-velocity saline waterjet guided by real-time ultrasound imaging and robotic precision to remove the prostate tissue causing obstruction — completely heat-free, with exceptional accuracy and consistent outcomes.
Aquablation therapy combines real-time transrectal ultrasound imaging with a computer-controlled robotic arm to map and remove precisely the obstructing prostate tissue using a high-velocity saline waterjet.
Because no heat is used, the risk of thermal damage to surrounding structures — including the nerves responsible for erectile and ejaculatory function — is minimized. The robotic system executes the treatment plan with sub-millimeter accuracy every time, regardless of prostate size or complexity.
Aquablation is particularly well-suited for men with large or complex prostates (over 80 cc) where other minimally invasive options may be less effective. It is performed in a hospital operating room under spinal or general anesthesia, typically with a one-night stay.
Spinal or general anesthesia is administered. The procedure is performed in a hospital operating room for patient safety and access to full surgical support.
A transrectal ultrasound probe creates a precise 3D map of the prostate. Dr. Sawkar uses this to define exactly which tissue needs to be removed.
The AQUABEAM robotic system executes the personalized treatment plan — delivering a high-pressure saline jet that removes tissue automatically along the planned path.
Most patients stay one night in the hospital. A catheter is typically in place for 1–2 days. Most men return to normal activities within 1–2 weeks.
Computer-controlled treatment delivery removes exactly the planned tissue — minimizing variability and improving outcomes regardless of surgeon experience.
No thermal energy means no heat-related damage to nerves, sphincters, or other critical structures surrounding the prostate.
Proven effective for small, medium, and large prostates (30–150+ cc), including complex anatomies that are challenging for other approaches.
Clinical studies show superior preservation of ejaculatory function compared to TURP, making Aquablation a preferred option for sexually active men.
Supported by multiple randomized controlled trials, including WATER and WATER II, demonstrating non-inferiority and safety compared to TURP.
Most patients are discharged within 24 hours and return to normal activities within 1–2 weeks — significantly faster than traditional open prostate surgery.
| Feature | Aquablation | TURP | HoLEP |
|---|---|---|---|
| Heat Used | ✓ Heat-free (saline only) | ✗ Electrical / thermal | ✗ Laser heat |
| Robotic Guidance | ✓ Fully robotic | Manual | Manual |
| Ejaculatory Function | ✓ Superior preservation | ✗ Retrograde ejaculation common | ✗ Retrograde ejaculation common |
| Large Prostates (>80 cc) | ✓ Excellent | Limited | ✓ Effective |
| Anesthesia | Spinal or general | Spinal or general | General |
| Hospital Stay | ~1 night | 1–2 nights | 1 night |
| Outcome Consistency | ✓ Robotic reproducibility | Operator-dependent | Operator-dependent |
Aquablation is an excellent option for men who need surgical-level tissue removal but want to avoid the side effects of traditional surgery. It is particularly suited for men with larger or more complex prostates.
Aquablation may be right for you if you:
TURP uses an electrified loop to cut and cauterize prostate tissue — generating heat that can damage surrounding nerves and structures. Aquablation uses a heat-free high-pressure waterjet guided by robotics and ultrasound, which provides more precise tissue removal with better preservation of sexual function and more consistent outcomes.
Most patients are discharged the morning after the procedure. A catheter is typically removed within 1–2 days. Light activities can resume within a week, and most men return to full normal activity within 2 weeks. Driving restrictions typically apply for 24–48 hours post-anesthesia.
Aquablation has the best ejaculatory function preservation rate among surgical BPH treatments — significantly better than TURP. In clinical trials, rates of retrograde ejaculation with Aquablation were dramatically lower than with traditional resection. Erectile function is generally maintained as well, since no heat is applied near the neurovascular bundles.
Multiple randomized controlled trials (WATER, WATER II) have demonstrated that Aquablation provides symptom relief and urinary flow improvement comparable to TURP — the historical gold standard — at 1 and 2 years, with superior sexual function outcomes. Longer-term follow-up data continues to support its durability.
Aquablation is covered by Medicare and many major insurance plans. Coverage for specific plans varies. Our team will verify your benefits before scheduling and work with you to understand any out-of-pocket costs.