Benign prostatic hyperplasia (BPH) is a common urologic condition that frequently affects men over the age of 50. It typically causes symptoms such as difficulty urinating, a persistent sensation of incomplete bladder emptying, and nocturia. Traditional prostate resection procedures have long been considered a standard treatment. However, outcomes can vary depending on the surgeon’s experience and the size of the prostate. In addition, potential complications such as erectile dysfunction, retrograde ejaculation, and urinary incontinence have made many patients hesitant to undergo surgery.
Recently, a newer treatment method known as Aquablation, a waterjet-assisted robotic surgery, has been introduced and is gaining wider adoption as it addresses some of these limitations. Aquablation removes enlarged prostate tissue using a high-pressure waterjet. Because the procedure does not generate heat, it minimizes damage to surrounding tissues.
Before the procedure, the surgeon precisely maps the treatment area using ultrasound and endoscopic imaging. Once the plan is established, the robotic system removes the targeted tissue accurately and consistently according to the predefined plan. The procedure typically takes about 7 to 15 minutes and, in many cases, patients may be discharged on the same day, significantly reducing recovery burden. It is also associated with a lower risk of urethral stricture or bladder neck contracture while offering effective improvement in urinary symptoms.
However, as with any medical treatment, Aquablation is not suitable for every patient. Individual patient evaluation is essential prior to the procedure. Factors such as prostate size and shape, coexisting medical conditions, and the patient’s suitability for anesthesia must be carefully considered. In particular, elderly patients or those with underlying cardiovascular disease require more cautious assessment.
Postoperative care is also important. Some patients may experience temporary urinary frequency or changes in urination patterns shortly after surgery, but these symptoms generally improve over time. Regular follow-up examinations and consultations with the treating physician are recommended to ensure proper recovery.
While robotic technology enhances the precision and consistency of the procedure, the responsibility for surgical planning, confirming hemostasis, and managing the patient’s overall condition still lies with the surgeon. For this reason, choosing a physician with extensive clinical experience remains a key factor in ensuring safety and patient satisfaction.
Aquablation has the potential to serve as an innovative treatment option for patients with BPH, offering a lower risk of complications, faster recovery, and the ability to treat prostates of various sizes compared with traditional surgical methods. However, optimal results depend on individualized treatment decisions, thorough preoperative consultation, and consistent postoperative care, supported by both medical expertise and patient cooperation.
Dr. Kim Jae-woong
Goldman Urology Clinic, Gangnam Branch