A robotically guided water jet that removes prostate tissue without heat. I think it is one of the best resective procedures for an obstructive prostate, and I have done a lot of them with great results. With my move to Peri I no longer work in the hospital, so I am not offering it, but my former partners at Summit Urology do it well, and I am happy to recommend them.
How it works
Aquablation uses a high pressure jet of water, guided robotically, to remove the obstructing part of an enlarged prostate. The surgeon first maps the target using ultrasound, marking exactly which tissue to remove and which to leave, and the robot then executes that plan.
Because the cutting is done by water rather than heat, the tissue around it is not burned. That matters for the structures responsible for ejaculation and continence.
Why I think it is a good procedure for large prostates
It handles a wide range of prostate sizes, including larger glands that limit some of the other minimally invasive options, and it does that with low rates of ejaculatory and continence problems. I truly believe it is a genuinely good procedure, and I am proud to have been an early adopter of the innovation.
Availability
I am not performing Aquablation at Peri Health & Hormones. It is done under anesthesia in an operating room, and depending on the patient it can require a hospital stay, which is outside what I am set up to offer at Peri Health & Hormones.
If Aquablation is the right answer for your prostate, I would rather tell you that and help you find it than steer you toward something I do offer.
The risks, honestly
Most men do well. Expect more blood in the urine early on than with the office based treatments, an overnight stay with a catheter in many cases, and the usual risks that come with anesthesia. Most men have a moderate amount of discomfort while the catheter is in, but usually start to feel better as soon as it comes out. Urinary urgency can last a few weeks before it settles.
Every procedure carries a small risk of a serious adverse event, including ones that did not appear in the original trials. Trials enroll selected patients in limited numbers, and rare events tend to surface later in wider use. That is true of every procedure on this site, and Aquablation is not exempt from it.