What Is Aquablation and How Does It Treat Benign Prostatic Hyperplasia (BPH)?

Most men will experience benign prostatic hyperplasia, or BPH, as they age. This noncancerous condition causes the prostate to enlarge, which can interfere with urination.

Various treatment options are available for BPH, including procedures like laser therapy or traditional surgery. Many of these older surgical treatments offer symptom relief but have side effects.

Aquablation is our new approach to BPH treatment that minimizes the risk of developing these side effects. This remedy comes in the form of a minimally invasive surgical procedure that uses robotics and a high-pressure water jet to destroy and remove excess prostate tissue.

What is Aquablation therapy and how does it work?

Aquablation is a trademarked name for a BPH treatment that was approved by the Food and Drug Administration in December 2017.

In recent years, this robotic waterjet ablation therapy has gained wider use as a treatment for enlarged prostates. In 2023, Ochsner Health became the first healthcare organization in Louisiana to offer Aquablation therapy for the treatment of lower urinary tract symptoms due to BPH, such as a weak urinary stream, frequent urination or difficulty emptying the bladder.

This modernized treatment involves a two-step process that occurs while the patient is under general anesthesia.

First, doctors use ultrasound imaging to create a surgical map that is customized to the individual patient’s anatomy. This is done with a tiny camera that is inserted into the urethra and a small ultrasound probe placed in the rectum.

The multi-dimensional map gives surgeons a clear picture of what prostate tissue needs to be removed.

In the second step of the process, a robotically controlled heat-free water jet follows the surgical map precisely and removes only the prostate tissue that is responsible for causing urinary problems.

The resulting precision of the waterjet ablation therapy prevents damage to other tissues and structures in the urinary tract, thereby reducing the risk of postoperative ejaculation problems, urinary incontinence and other complications.

The entire procedure usually takes about 30 minutes. Patients often can go home the same day as the surgery, but some stay in the hospital for one night. Typically, the patient is discharged with a catheter for several days, which is removed in the office. Patients are advised to avoid strenuous activities for 1-2 weeks after surgery.

Prostate health

Scientists don’t know the exact cause of BPH. It may have to do with changes in the balance of sex hormones as men grow older.

The prostate is a gland located in front of the rectum. It surrounds the urethra and is normally about the size of a walnut.

For most men, the prostate begins to grow as they reach their 30s and continues to do so for the rest of their lives. As a result, a significant number of men develop BPH.

The larger the prostate, the more likely it is to squeeze the urethra, the tube that carries urine and semen out of the penis. This can cause the urine stream to be weak, which usually lead to more trips to the bathroom.

While men can't completely prevent BPH, adopting a healthy lifestyle with regular exercise, a balanced diet, and managing weight can help reduce and potentially slow down prostate growth.

Studies have shown that having BPH doesn’t increase a man’s chances of developing prostate cancer. However, BPH and prostate cancer have similar symptoms so it’s important to be wary of any problems that may occur during urination.

The American Urological Association encourages men to be proactive rather than reactive regarding their prostate health.

The AUA says men ages 45 to 69, with an average risk for prostate cancer, should talk to their doctor about whether prostate cancer testing is right for them. For men with a higher risk of getting prostate cancer, they should consider talking to their doctor as early as 40-54 years of age. Things that increase your risk include a family history of prostate cancer, smoking, or African-American heritage.

According to the American Cancer Society, cases of prostate cancer are rising each year, with a 3% per year increase since 2014 and a 5% per year increase in advanced prostate cancer diagnoses. It is estimated that nearly 314,000 men will be diagnosed with prostate cancer in 2025 and some 36,000 will die from it. Rest assured that our team at Ochsner is dedicated to providing the latest and greatest developments in the diagnosis and treatment of both BPH and prostate cancer.