“Aquablation represents one of the most significant innovations in prostate surgery in recent years. It allows us to remove obstructive prostate tissue with extraordinary precision, while preserving sexual function and reducing the need for repeat treatment. It’s a great example of how technology can make a real difference for men’s quality of life.”
If you’ve been struggling with slow urine flow, frequent night-time trips to the toilet, or the feeling that your bladder never quite empties, you’re not alone. These are all common symptoms of benign prostatic hyperplasia (BPH) — a non-cancerous enlargement of the prostate that affects many men as they get older.
For decades, treatment options were limited to either long-term medication or traditional surgery such as a TURP (Transurethral Resection of the Prostate).
While effective, these older approaches can cause unwanted side effects — especially changes to sexual function.
The good news is that modern medicine now offers minimally invasive alternatives designed to relieve symptoms effectively, while reducing side effects and recovery time.
One of the most advanced and exciting of these options is called Aquablation.
What Is Aquablation?
Aquablation is a robotic-assisted surgical treatment for urinary symptoms caused by BPH.
Instead of using heat (as in laser or cautery procedures), it uses a high-pressure jet of water to remove excess prostate tissue that is blocking urine flow.
The key to Aquablation’s precision lies in the combination of real-time ultrasound and camera guidance (cystoscopy). These two imaging methods allow your urologist to see both the inside and outside of the prostate simultaneously during surgery.
Once the prostate anatomy is mapped, your surgeon programs the robotic system to remove only the overgrown tissue — avoiding sensitive areas that control ejaculation and urinary continence.
Because the water jet is computer-guided, every millimetre of tissue removal is planned in advance, ensuring safety, consistency, and accuracy.
How the Procedure Works
Anaesthesia: Aquablation is performed under a general anaesthetic.
Imaging: A small ultrasound probe is placed in the rectum to create a detailed map of your prostate, while a camera is inserted through the urethra.
Planning: Your surgeon identifies which tissue needs to be removed and which areas (like the ejaculatory ducts and verumontanum) should be preserved.
Treatment: A robotic-controlled water jet removes the targeted tissue in just a few minutes.
Completion: Bleeding areas are controlled, and a catheter is placed temporarily to allow urine to drain as healing begins.
Most men stay in hospital for one night and have the catheter removed the next day.
The Benefits of Aquablation
✅ Effective Symptom Relief
Large clinical studies show that Aquablation provides excellent improvements in urinary flow and symptom scores, often greater than those seen with traditional TURP.
✅ Long-Term Durability
In the landmark WATER clinical trial, men treated with Aquablation had fewer repeat procedures and a lower need for medication compared to those who had a TURP, even five years later.
Reintervention after TURP: ~17.6% at 5 years
Reintervention after Aquablation: ~13.2% at 5 years
✅ Preserves Sexual Function
Because Aquablation uses no heat, it avoids damage to nearby erectile nerves.
In the WATER study, no men experienced new erectile dysfunction after Aquablation.
✅ Lower Risk of Retrograde Ejaculation
Retrograde ejaculation — where semen flows backward into the bladder instead of out — affects up to 80% of men after TURP.
With Aquablation, this risk is significantly lower at around 15%, thanks to the ability to spare the ejaculatory ducts.
✅ Suitable for Many Prostate Sizes
The WATER II study confirmed that Aquablation is effective even for larger prostates (80–120cc), with more than 96% of men avoiding further surgery or treatment after five years.
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Risks and Recovery
As with any surgery, Aquablation carries some risks.
Because no heat is used, there can be a slightly higher chance of bleeding immediately after the procedure compared to laser treatments. However, this is usually temporary and managed effectively with short-term catheterisation and observation in hospital.
Most men return to normal activities within a week or two, though it can take a few weeks for urinary symptoms to fully settle as the prostate heals.
Who Might Benefit from Aquablation?
Aquablation may be suitable if you:
Have moderate to severe urinary symptoms due to BPH
Have a medium to large prostate (typically >40cc)
Want to preserve sexual function
Have not achieved good results from medication
Prefer a minimally invasive treatment with durable outcomes
Your urologist can assess your prostate size, shape, and overall health to help determine whether Aquablation is right for you.
Availability in Australia
At present, Aquablation is not yet available in Australia.
Although the treatment has been approved and widely adopted in countries such as the United States and parts of Europe, it is still undergoing regulatory assessment and approval processes locally.
Before it can be offered in Australia, the technology must meet Therapeutic Goods Administration (TGA) requirements and be supported by appropriate training, infrastructure, and hospital integration.
Final Thoughts
Aquablation is a significant step forward in the treatment of BPH.
It delivers durable symptom relief comparable to traditional surgery, but with the added advantages of robotic precision, preservation of sexual function, and a faster recovery.
If urinary symptoms are affecting your quality of life, don’t ignore them. There are safe, effective, and modern options available — and Aquablation may be one of them.