Dr. Ryu Kyung-ho, Director of Goldman Urology Clinic Gangnam Branch
Benign prostatic hyperplasia (BPH) is a common urologic condition among middle-aged and older men. As men age, the prostate gland can enlarge abnormally and compress the urethra, leading to urinary difficulties. If left untreated, BPH may cause complications such as acute urinary retention, decreased kidney function, and urinary tract infections, making early diagnosis and treatment essential.
In the early stages, symptoms can often be managed with medication. However, when long-term medication becomes ineffective, causes side effects, or when urinary symptoms become severe or complications are likely, surgical treatment may be required. The traditional surgical approach, transurethral resection of the prostate (TURP), has raised concerns due to potential heat-related tissue damage, delayed recovery, and possible effects on sexual function.
To address these limitations, a newer treatment method called aquablation, also known as waterjet robotic surgery, has gained attention. This technique uses a high-pressure waterjet to precisely remove enlarged prostate tissue without causing thermal damage. The procedure is guided by real-time ultrasound and endoscopic imaging, allowing surgeons to accurately design the resection area. By avoiding heat, the technique helps minimize damage to surrounding healthy tissue and supports faster recovery.
One of the most concerning complications of prostate surgery is retrograde ejaculation, a condition in which semen flows backward into the bladder during ejaculation. This can negatively affect reproductive function and psychological satisfaction. Waterjet robotic surgery incorporates anatomically precise surgical planning designed to preserve ejaculatory function, thereby reducing the risk of this complication.
Another advantage of waterjet surgery is that it can be applied regardless of the size or shape of the prostate. Because the procedure is designed using detailed anatomical information, it allows a customized surgical approach tailored to each patient. In addition, patients generally experience faster recovery, a lower rate of postoperative complications, and high levels of satisfaction after the procedure.
Ultimately, the goal of BPH surgery is not simply to remove enlarged tissue but to preserve and improve the patient’s overall quality of life. In particular, preserving ejaculatory function has become an important outcome measure. Waterjet robotic surgery is considered a treatment method supported by both technological and clinical evidence that meets these goals.
Dr. Ryu emphasized that even the most advanced surgical technology ultimately depends on the surgeon’s anatomical understanding and level of experience. Careful planning of the resection area before surgery and meticulous confirmation of tissue preservation afterward are essential to achieving the best possible outcomes.