Home › Treatments › Aquablation
Treatment
Aquablation for an enlarged prostate
A robotic, image-guided waterjet operation for the symptoms of an enlarged prostate. Mr Swallow is trained in Aquablation as well as HoLEP, and can help you choose between them.
Written and clinically reviewed by Mr Daniel Swallow, Consultant Urologist (GMC 6128674). Last reviewed: .
What is Aquablation?
Aquablation is an operation for benign (non-cancerous) prostate enlargement. A robotic, image-guided system uses a high-pressure jet of saline (salt water) to remove the prostate tissue that is blocking the flow of urine. The surgeon plans the area to be treated using live ultrasound pictures of your own prostate, and the robot then carries out that plan. The waterjet cuts without using heat.
Who might it suit?
Aquablation is for men whose urinary symptoms from an enlarged prostate (a weak stream, hesitancy, getting up at night, incomplete emptying or a catheter) have not been controlled by lifestyle changes and tablets, and who need an operation. It can be used across a wide range of prostate sizes. As with HoLEP, the choice depends on the size and shape of your prostate, your general health and medicines, and what matters most to you. See enlarged prostate for the full picture of treatment options.
Mr Swallow is trained in both Aquablation and HoLEP, so his advice is not tied to one operation. In a consultation he will explain how each works, how they differ for a prostate like yours, and what you can expect from each.
What to expect
- 1Assessment
A review of your symptoms, a flow test, an ultrasound or other scan to look at your prostate, and a review of your medicines. A PSA test is discussed where appropriate.
- 2The operation
Done under anaesthetic. A probe in the urethra guides the robot, and the planned area of prostate is removed with the waterjet. A catheter is placed at the end to help the area heal and to wash out any blood.
- 3Recovery in hospital
Most men stay in hospital for a night or two. Mr Swallow will tell you when your catheter will be removed, which depends on your recovery.
- 4Follow-up
A review to check your recovery and urine flow, and to talk through how things are going.
Possible after-effects and risks
As with any operation on the prostate, burning, urgency and some blood in the urine are common in the first days to weeks and usually settle on their own. Less commonly there can be further bleeding, infection, difficulty passing urine after the catheter is removed, or leakage of urine, and some men need further treatment. Aquablation can still affect ejaculation (semen passing back into the bladder, a “dry orgasm”) and, rarely, erections, so this is worth discussing before surgery, especially if you may want to have children. Mr Swallow will talk through the risks as they apply to you.
you cannot pass urine, you pass clots that block the flow, the bleeding is heavy or not settling, or you develop a fever or severe pain. Contact the hospital team you were given details for, or call NHS 111 or go to A&E.
Cost and insurance
Aquablation is available with Mr Swallow privately, either through medical insurance or self-pay. Cover depends on your insurer and policy, so it is worth checking with them before you book. For self-pay prices, or help with an insurer, ask the private secretary on 01245 234414. See private patients.
Common questions
What is the difference between Aquablation and HoLEP?
Both treat benign prostate enlargement by removing the tissue that blocks urine flow. HoLEP uses a laser to free the obstructing tissue, while Aquablation uses a robotic, image-guided waterjet. Mr Swallow performs both, and can advise on which is more suitable for you.
Is Aquablation a new treatment?
It is a newer operation than TURP, and NICE has published guidance on it. Mr Swallow is trained in it and will explain what is known about its results and how they compare with other options.
Will I need a catheter afterwards?
Yes, a catheter is placed at the end of the operation. How long it stays in depends on your recovery, and Mr Swallow will tell you before you go home.
Does Aquablation treat prostate cancer?
No. It is for benign prostate enlargement. If there is any concern about prostate cancer, that is looked into separately, and you can read more under prostate cancer diagnosis.
Discuss this with Mr Swallow in London or Chelmsford
Talk through Aquablation and HoLEP with Mr Swallow. You can book online, or call the private secretary.
Further reading from trusted sources
- NHS: Enlarged prostate
- NICE CG97: Lower urinary tract symptoms in men
- BAUS: Aquablation patient information leaflet
Information on this page follows patient guidance published by the British Association of Urological Surgeons (BAUS). External links open on the NHS and NICE websites, which are not run by Mr Swallow.