Benign prostatic hyperplasia (BPH) is one of the most common urologic conditions affecting middle-aged and older men. It can cause significant discomfort in daily life by leading to urinary problems and reducing overall quality of life. Typical symptoms include a sensation of incomplete bladder emptying, frequent urination, nighttime urination, and a weak urinary stream. If left untreated, the condition may progress to serious complications such as decreased kidney function, making early treatment important.
In the early stages, medication can help relieve symptoms. However, when long-term medication shows limited effectiveness or causes side effects, surgical treatment may become necessary. Traditional surgical methods often remove tissue using high temperatures, which may lead to concerns about bleeding, pain, longer recovery periods, and reduced ejaculatory function. Because of these concerns, some patients hesitate to undergo surgery.
To address these issues, a newer treatment option known as aquablation has recently gained attention. Aquablation, often referred to as waterjet robotic surgery, uses a high-pressure water stream to remove enlarged prostate tissue. Because it does not rely on heat, it minimizes damage to surrounding healthy tissue and reduces complications associated with thermal injury.
During waterjet robotic surgery, the surgeon precisely controls the resection area using cystoscopic visualization and real-time ultrasound imaging. The average procedure time is relatively short, typically around 7 to 15 minutes. In many cases, patients can be discharged on the same day, which helps reduce both physical and psychological burdens.
Among urology specialists, there is growing recognition that preserving ejaculatory function depends less on the bladder neck and more on how effectively the verumontanum—the area where semen is expelled—and surrounding structures are preserved. Aquablation offers precise control that allows surgeons to maintain these critical structures, making it advantageous in terms of both surgical precision and functional preservation.
However, achieving optimal surgical outcomes and patient satisfaction requires a thorough evaluation of factors such as prostate size, shape, and the duration of symptoms before surgery. Based on this information, an experienced surgeon must determine the appropriate surgical plan. Patients are also advised to confirm whether the hospital provides a system that supports same-day admission, surgery, and discharge, as well as whether appropriate equipment and procedures are in place to respond to emergencies such as power outages.
Dr. Kim Jae-woong of Goldman Urology Clinic’s Gangnam branch explained that BPH surgery is not simply about removing enlarged tissue but about preserving and improving the patient’s quality of life and functional outcomes. He noted that aquablation is increasingly recognized as a next-generation surgical method that meets these standards. He also emphasized that choosing a medical institution with accurate diagnostic capabilities and a well-organized treatment system tailored to each patient’s condition is essential for successful treatment.