Aquablation therapy is an innovative, minimally invasive procedure that uses a robotically controlled heat-free waterjet to treat a symptomatic enlarged prostate.

Reviewed by Mr Neil Barber, Consultant Urological Surgeon

What is Aquablation?

Aquablation is an innovative new therapy for patients with symptoms resulting from an enlarged prostate. 

Enlarged prostate, also known as benign prostate enlargement (BPE) or benign prostatic hyperplasia (BPH), is when the prostate increases in size and causes problems with urination. 

Aquablation uses a heat-free waterjet to remove the obstructing prostate tissue, which improves urinary function. The procedure provides long-lasting relief and benefits from a very low rate of irreversible complications.

The Aquablation service at Cromwell Hospital is run by Mr Neil Barber, Consultant Urological Surgeon, who introduced the procedure to the UK in 2019.  

What happens during the Aquablation procedure?

Aquablation is delivered using an advanced robotic system called AquaBeam. AquaBeam combines real-time imaging, automated robotic technology, and heat-free waterjet ablation to safely and effectively remove obstructive prostate tissue.

You will be placed under general anaesthesia for the procedure, which usually takes up to an hour to complete.

The first stage of the procedure is treatment mapping. To do this, your consultant will use a combination of ultrasound imaging and a long, thin instrument called a cystoscope, which has a camera on one end. This allows the consultant to see and treat the prostate in real time, providing greater precision and accuracy.

The ultrasound device is placed into the rectum, while the cystoscope is guided through the urethra (tube that carries urine out of the body) to access the prostate – meaning that no incisions are required.

Once the surgeon has mapped out the area to treat, the robotically controlled heat-free waterjet is used to remove the obstructive prostate tissues. This part of the procedure takes less than ten minutes to complete.

Following the procedure, a catheter will be fitted to allow urine to drain while you recover.

The main benefit of Aquablation over other enlarged prostate treatments is the low rate of irreversible complications, such as incontinence, ejaculatory dysfunction, and erectile dysfunction.

This is because the procedure uses real-time imaging for enhanced precision, and also because the treatment does not involve heat. In treatments that use heat, there is a risk that the parts of the prostate that control ejaculatory and erectile function could become damaged.

Following the procedure, patients will stay one to two nights in hospital.

Most patients will have their catheter removed prior to discharge. If a patient is struggling to wee, they may be sent home with their catheter for a further few days. 

Some patients may experience a burning sensation when weeing, increased urgency and frequency, and/or a small amount of blood in the urine, which can last for a couple of weeks – this should go away in time, and by four weeks most patients are able to resume normal activities. It can take a few months to recover fully.

Benefits of Aquablation

There are several benefits to Aquablation over other enlarged prostate treatments. 

In clinical studies for Aquablation, no patients that received the treatment developed problems with erectile function, orgasmic function, sexual desire, intercourse satisfaction, or overall sexual satisfaction – complications which can be more common in other procedures. 

Aquablation therapy is less likely to cause damage to surrounding healthy tissues than other types of procedure. This is because it utilises real-time imaging, which offers greater precision, and because it is heat-free. Procedures that use heat to remove the enlarged prostate tissue may affect the parts of the prostate that control erectile function and ejaculatory function. 

Aquablation also has a short procedure completion time – under ten minutes to remove the enlarged prostate tissue, and around one hour in total including treatment mapping. Longer resections carry a higher risk of complications. 

Aquablation consultants in London

The Aquablation service at Cromwell Hospital is led by Mr Neil Barber, who specialises in the minimally invasive treatment of enlarged prostate.

Paying for your treatment

We welcome both self-paying and insured patients.

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