If you have been told you have an enlarged prostate, you may be weighing up treatment for benign prostatic hyperplasia, often called BPH. Aquablation therapy is a robotically guided, heat-free treatment designed to relieve troublesome urinary symptoms while protecting continence and sexual function. Professor Prokar Dasgupta offers it using the HYDROS robotic system. This article explains how it works, who it suits and what you can expect.
What is Aquablation therapy?
Aquablation therapy is a minimally invasive treatment for BPH. It combines real-time imaging, robotic guidance and a heat-free waterjet to remove excess prostate tissue precisely. Older techniques use heat energy to cut or vaporise tissue, whereas Aquablation therapy avoids heat altogether.
This is one reason the procedure is associated with low rates of lasting side effects such as incontinence and problems with ejaculation or erections. The Aquablation therapy page gives an overview of the treatment.
Understanding an enlarged prostate
BPH is not prostate cancer. It happens when the prostate grows larger than normal and presses on the urethra, the tube that carries urine out of the body. This can make it harder to pass urine and, over time, puts strain on the bladder.
Common symptoms include a weak flow, needing to pass urine often or urgently, and getting up several times at night. The NHS guide to benign prostate enlargement describes the condition in more detail, and our page on benign prostatic enlargement explains the treatment options available.
How Aquablation therapy works
The procedure is carried out in two main stages during a single operation under anaesthetic.
Mapping the prostate
Using two forms of imaging, the surgeon builds a detailed, three-dimensional picture of the whole prostate rather than viewing it through a narrow telescope. A personalised plan is then mapped out, marking exactly which tissue should be removed. Just as importantly, it marks the areas linked to continence and ejaculation that should be protected.
Removing tissue with a waterjet
Once the plan is confirmed, a robotically controlled, heat-free waterjet removes the mapped tissue in a consistent, predictable way. Because the robot carries out the plan rather than relying entirely on manual technique, Aquablation therapy can treat prostates of many sizes and shapes, including those with an enlarged middle lobe.
Reported benefits
Clinical studies of Aquablation therapy have reported:
- a significant improvement in urinary symptom scores
- a meaningful increase in urine flow rate
- high rates of preserved continence
- high rates of preserved erectile function
- good rates of preserved ejaculation
These results matter because many men delay treatment out of concern for their sexual function. Aquablation therapy is designed to reduce that trade-off, offering lasting relief without necessarily compromising quality of life. Individual results vary, and your surgeon will discuss what is realistic for you.
Is Aquablation therapy right for you?
Aquablation therapy may suit men with small or large prostates, including those with a middle lobe that pushes into the bladder. A consultation is the best way to find out. Your prostate size and shape are assessed, your symptoms discussed, and your priorities considered, whether that is symptom relief, recovery time or preserving sexual function.
Other minimally invasive options may also be suitable, such as iTind or prostate artery embolisation. Independent guidance from NICE on transurethral water jet ablation sets out the evidence for the procedure.
Book a consultation
An enlarged prostate does not have to be something you simply put up with. Aquablation therapy with the HYDROS system offers a modern, minimally invasive route to lasting relief. Please contact the clinic to arrange a consultation and find out whether it is the right option for you.