If urinary discomfort persists, it is important to check whether there is an abnormality in the prostate. One possible cause is benign prostatic hyperplasia (BPH), a condition in which the prostate enlarges and compresses the urethra, leading to urinary problems.
Typical symptoms of BPH include a weak urinary stream, interruption of urine flow, a persistent sensation that urine remains in the bladder after urination, and frequent urination. This condition commonly occurs in middle-aged and older men and is closely associated with aging. Because it can significantly affect quality of life, individuals experiencing these symptoms are advised to visit a urology clinic for a detailed evaluation.
The diagnosis of BPH involves several tests. First, a medical interview is conducted to review the patient’s medical history and current medications. The severity of urinary symptoms is then assessed using the internationally standardized International Prostate Symptom Score (IPSS). Physical examinations, including a digital rectal examination, are performed to evaluate the size of the prostate and detect any nodules. Additional tests such as urinalysis to check for hematuria or urinary tract infection and a PSA (prostate-specific antigen) test to assess the possibility of prostate cancer are also carried out.
A uroflowmetry test and post-void residual urine test help evaluate the speed of urine flow and the amount of urine remaining in the bladder, which can indicate the presence of urinary obstruction. If necessary, cystoscopy may be performed to visually examine the bladder and urethra. Urodynamic testing and the UroCuff test can further help identify the precise cause of urinary symptoms. In addition, transrectal ultrasound is used to evaluate the size of the prostate and detect any abnormalities. Based on the results of these examinations, a personalized treatment plan is developed for each patient.
One of the treatment methods that has recently gained attention is aquablation, often referred to as waterjet robotic surgery. This technique uses a high-pressure water stream to precisely remove enlarged prostate tissue without causing thermal damage. It has received approval from the U.S. Food and Drug Administration (FDA) and has also been recognized as a new medical technology in Korea, demonstrating both safety and effectiveness. Unlike conventional transurethral resection of the prostate (TURP), aquablation does not involve heat, which helps minimize damage to surrounding healthy tissue.
During aquablation surgery, the surgical area is monitored in real time using ultrasound and an endoscope while a robotic system is precisely controlled to remove prostate tissue. For this reason, effective surgical outcomes depend on the combination of the surgeon’s experience and precise planning of the tissue removal area.
Although robotic surgical systems offer high technical precision, they also require rapid judgment and advanced expertise from the surgeon. The ability to interpret real-time ultrasound and endoscopic images and precisely control the robotic system without error demands extensive experience and technical skill. Therefore, selecting an experienced medical team is essential for safely handling any unexpected situations during surgery.
Additionally, each patient with BPH may differ in prostate size, shape, degree of bladder outlet obstruction, and the presence of complications. Physicians must carefully evaluate these individual characteristics and develop a tailored treatment strategy for each patient.
Dr. Kim Jae-woong of Goldman Urology Clinic’s Gangnam branch stated in a written interview on the 17th that one of the greatest advantages of aquablation is that it does not use heat, which significantly reduces the risk of damage to normal tissue and minimizes complications such as urinary incontinence and erectile dysfunction that may occur with traditional surgical methods. However, he emphasized that advanced technology alone cannot guarantee successful results, noting that the outcome of the surgery ultimately depends on the surgeon’s experience and skill.