[Hinews] [Physician's Column] By Geon Gil, Director of UWell Urology Clinic

Aquablation is a cutting-edge, minimally invasive treatment for benign prostatic hyperplasia (BPH), utilizing a high-velocity saline jet guided by a robotic system and real-time ultrasound imaging to precisely remove excess prostate tissue. Unlike traditional methods, this technique avoids thermal damage to surrounding tissues, relying instead on mechanical resection to minimize bleeding and complications. As a result, the procedure typically offers shorter operating times—averaging 30 to 40 minutes—and faster recovery periods.

The treatment yields improvements in urinary flow and symptom relief comparable to established procedures like transurethral resection of the prostate (TURP) or holmium laser enucleation of the prostate (HoLEP). However, aquablation is associated with a lower incidence of sexual dysfunction, such as retrograde ejaculation, a common concern with other surgical options.

Patient eligibility for aquablation is determined by evaluating prostate size, urinary flow test results, coexisting medical conditions, and expected outcomes. For instance, a 62-year-old patient, Mr. A, chose aquablation after his symptoms no longer improved with medication. His catheter was removed within 24 hours post-procedure, and normal urination resumed within a week, with no impact on sexual function. “I was concerned about ejaculation issues after hearing about other prostate surgeries, but I’m very satisfied with aquablation’s outcome,” Mr. A shared.
BPH, a common urological condition among older men, affects approximately 50% of men over 60 and up to 90% of those over 80. Initial treatment usually involves medication, but surgery is required when drugs become ineffective, cause side effects, or complications such as recurrent urinary tract infections, bladder stones, or acute urinary retention develop.

Geon Gil, Director of UWell Urology Clinic. (Photo courtesy of UWell Urology Clinic)
Geon Gil, Director of UWell Urology Clinic. (Photo courtesy of UWell Urology Clinic)


Developed to address limitations of conventional surgeries, aquablation leverages robotic precision and real-time ultrasound to deliver a high-pressure water jet that removes prostate tissue. The absence of heat reduces tissue damage, lowering risks of bleeding and complications. Additionally, the automated nature of the procedure minimizes variations due to surgeon experience, enhancing consistency.

Clinical studies, both domestic and international, report significant improvements following aquablation. Patients typically see their International Prostate Symptom Score (IPSS) drop by over 60%, alongside marked increases in maximum urinary flow rate (Qmax). For example, Mr. B, a 55-year-old office worker, struggled with medication adherence due to his demanding 9 a.m. to 6 p.m. work schedule. After undergoing aquablation, his IPSS improved from 22 to 6 within three months, and his quality-of-life score rose significantly. “The anxiety around urination is gone, and both my work efficiency and social life have improved,” Mr. B noted. Such cases highlight aquablation’s role in not only alleviating symptoms but also enhancing overall quality of life.
In conclusion, aquablation represents a promising advancement in BPH treatment, overcoming limitations of traditional surgeries while offering safety and efficiency. However, its application should be tailored to individual factors, including prostate size, comorbidities, patient preferences, and clinician expertise. As long-term studies continue to build evidence on its sustained efficacy and safety, aquablation is poised to become a standard treatment option for BPH.

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