Aquablation of the prostate at Rowley Hall Hospital in Stafford

What is an enlarged prostate (BPH)?

An enlarged prostate, known medically as benign prostatic hyperplasia (BPH) is a very common, non-cancerous condition where the prostate gradually grows with age and begins to press on the urethra, making it harder to pass urine. Many men search for what is the best treatment for enlarged prostate when symptoms begin to affect daily life.

The prostate is a small gland that sits just below the bladder and surrounds the urethra. Its main role is to produce seminal fluid. With age, hormonal changes trigger a second growth phase in the gland. BPH occurs when noncancerous prostate cells divide to make more cells, causing the gland to enlarge. 

As the prostate expands, it narrows the urethra and forces the bladder to work harder, which can lead to symptoms such as a weak or slow flow, hesitancy when starting, urgency, nocturia (getting up at night), and a persistent feeling of incomplete emptying.

Although BPH is benign and does not increase the risk of prostate cancer, the two conditions can occur at the same time and share similar symptoms, which is why proper assessment and diagnosis matter. 

Many men begin with medication, but sexual side effects are a common reason they explore surgical options like Aquablation, a precise, heat-free enlarged prostate treatment that preserves sexual function.

What is Aquablation therapy and how does it work?

Aquablation therapy is an advanced, minimally invasive treatment for BPH. It uses the AquaBeam robotic system to remove excess prostate tissue with a precisely controlled, heat-free waterjet. 

The system combines real-time ultrasound imaging with a cystoscope camera to give the surgeon a detailed, 3D view of the prostate from both inside and outside. 

Step 1 - Surgical mapping
The procedure begins with a personalised treatment map. Using live ultrasound, the surgeon outlines exactly which prostate tissue needs to be removed while clearly marking the areas that must be protected including the nerves responsible for erections, ejaculation, and continence. This planning stage ensures the treatment is tailored to the patient’s anatomy and helps safeguard sexual and urinary function.

Step 2 - Robotic resection
Once the map is confirmed, the AquaBeam system delivers a high-velocity waterjet that follows the plan with millimetre precision. The resection typically takes just three to five minutes and uses no heat at any stage. This heat-free approach is important because it avoids thermal injury to surrounding structures, reducing the risk of side effects. 

Aquablation works for prostates of all sizes and shapes, including those with obstructive median lobes, and is endorsed by NICE as a standard treatment option (IPG629 and MIB315).

Who is suitable for Aquablation?

Aquablation is suitable for men with moderate to severe BPH symptoms who are not getting enough relief from medication or who want to avoid the sexual side effects often associated with procedures that use heat, such as TURP or laser treatments. It is often chosen by men comparing what is the best treatment for enlarged prostate options.

Because Aquablation uses a heat-free waterjet and robotic precision, it is an option for prostates of all sizes and shapes including very large glands and those with obstructive median lobes, where other procedures may be less effective.

It may not be suitable for men with an active urinary infection or significantly impaired kidney function, and a consultant assessment is essential to confirm safety and suitability. Before recommending Aquablation, your urologist will usually carry out a full pre-operative assessment, which may include an IPSS symptom score, uroflowmetry to measure urine flow, ultrasound to assess prostate size and bladder emptying, and sometimes cystoscopy to look inside the urethra and bladder.

When discussing Aquablation with your consultant, helpful questions to ask include:

• How big is my prostate, and what is the measurement?
• Does my prostate have a lobe protruding into the bladder?
• Will I maintain sexual function and get meaningful symptom relief with medication or other procedures?
• Why might Aquablation be a better option for my anatomy or symptoms?

Aquablation vs other prostate treatments

Aquablation offers men a way to treat BPH without having to choose between strong symptom relief, a long recovery, or the risk of sexual side effects, a compromise that is common with many other prostate treatments. Here we compare the main options for enlarged prostate treatment.

Medication
Tablets such as alpha-blockers and 5-alpha-reductase inhibitors can ease symptoms, but the effect is often modest and may take months. Sexual side effects including reduced libido, erectile difficulties, and ejaculatory changes are common reasons men look for alternatives.

TURP (Transurethral Resection of the Prostate)
A long-established surgical option that removes prostate tissue using an electric loop. TURP provides reliable symptom relief but uses heat, which increases the risk of retrograde ejaculation and other sexual side effects. Recovery can involve a hospital stay and catheter time.

HoLEP (Holmium Laser Enucleation of the Prostate)
A highly effective laser procedure suitable for large prostates. Like TURP, it uses heat, so sexual side effects, particularly ejaculatory dysfunction, are common. Recovery is generally quicker than TURP, but the technique is operator-dependent.

UroLift
A minimally invasive option that lifts prostate tissue away from the urethra using implants. It preserves ejaculation but is best suited to smaller prostates and may not be effective for men with a median lobe. Symptom improvement is often less dramatic than resective surgery.

Rezum
Uses steam to destroy prostate tissue. It is minimally invasive and preserves sexual function for many men, but symptoms can take weeks to improve, and it is less suitable for larger prostates or complex anatomy.

Aquablation
Aquablation combines the durability of resective surgery with the lower complication profile of minimally invasive treatments. Using real-time ultrasound and a robotic, heat-free waterjet, it removes tissue precisely while protecting the nerves responsible for erections, ejaculation, and continence. 

In clinical studies, including the WATER trial, Aquablation delivered symptom relief comparable to TURP at five years, with significantly fewer sexual side effects. In fact, 83% of men maintained ejaculatory function, a powerful reassurance for those concerned about quality of life.

Benefits of Aquablation therapy

Aquablation therapy offers a unique combination of effective symptom relief, preserved sexual function, and rapid recovery, making it an appealing option for many men with BPH.

• Preserves sexual function - around 7% risk of retrograde ejaculation, compared with 60 to 70% after TURP

• Strong symptom relief - significant improvements in IPSS scores (measures urine symptom severity) and urine flow

• Works for all prostate sizes and shapes, including very large glands and median lobes

• No thermal injury - heat-free waterjet protects surrounding nerves and structures

• Personalised treatment map and robotic precision reduce operator variability

• Procedure typically under 60 minutes, with catheter removal in 24 to 48 hours

• NICE-endorsed as a standard treatment option, with 5-year WATER trial data confirming durable results

• Supported by the Elterman meta-analysis - showing strong functional outcomes and high rates of sexual function preservation

What to expect during the Aquablation procedure

Before the procedure, you’ll have a pre-operative assessment that may include fasting instructions, an anaesthetic review, an IPSS symptom score, and an ultrasound to assess your prostate and bladder. 

Aquablation is carried out under either general or spinal anaesthesia. In theatre, the surgeon uses an ultrasound probe and a cystoscope to create a real-time 3D view of the prostate. A personalised treatment map is drawn, and the robotic waterjet follows this plan to remove the obstructive tissue. 

The procedure usually takes under 60 minutes, with no external incisions and no heat used at any stage. Afterward, a catheter is inserted, and most men stay in hospital overnight. The catheter is typically removed within 24 to 48 hours. The robotic system ensures consistent precision throughout the procedure.

Recovery after Aquablation of the prostate

Aquablation recovery time varies from patient to patient. Here is a typical recovery timeline:

Most men stay in hospital for 1 to 2 nights after Aquablation. 

During the first one to two weeks at home, rest is encouraged. Light walking is fine, but heavy lifting and strenuous activity should be avoided. It’s normal to notice some blood in the urine during this period. 

By weeks 2 to 4, many men begin to experience significant improvement in urinary symptoms and can usually return to desk-based work. 

From six weeks onwards, most people can resume full physical activity and sexual activity, following their consultant’s advice. 

A follow-up outpatient appointment will be arranged to check your recovery and symptom progress. You should contact your clinical team if you develop a fever, are unable to urinate, or notice significant bleeding.

Why choose a private prostate Aquablation procedure?

Many men choose to have a prostate Aquablation procedure privately for the following reasons:

• Faster access to treatment, with no long waiting lists

• Consultant-led care throughout, with a urologist experienced in Aquablation

• Advanced robotic and imaging technology available in modern private theatres

• Personalised treatment planning and time to discuss all your options

• Comfortable private rooms and dedicated nursing support during your stay

• Flexible appointment times and rapid access to diagnostics

• Streamlined pathways from consultation to procedure and follow-up

• Continuity of care, with the same specialist overseeing your recovery

Aquablation of the prostate cost at Ramsay

Aquablation is offered at Ramsay Health Care with a fixed, all-inclusive Total Care price, which covers your procedure, hospital stay, and aftercare. 

Your consultant will confirm whether Aquablation is suitable for you, and you’ll receive a detailed personalised quote after your initial consultation, so you know exactly what to expect with no hidden charges.

Aquablation of the prostate at Ramsay Health Care

Ramsay Health Care offers Aquablation of the prostate across multiple UK hospitals, using the latest PROCEPT BioRobotics technology to deliver precise, heat-free prostate tissue removal. 

All procedures are carried out by trained, accredited consultant urologists with specialist experience in robotic BPH surgery, giving you expert care at every stage. 

Our private patients benefit from fast access to consultations, diagnostics, and treatment with no long waits and no GP referral required.

Watch our patient’s aquablation experience to find out what treatment and recovery are really like. 

Find your nearest hospital, book online or call us on 0808 223 0500.

Aquablation of the prostate FAQs