Aquablation: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Aquablation?
A urologist, a doctor who treats the urinary tract and male sex organs, performs aquablation. It is a robot-guided procedure done in a hospital. It needs anesthesia. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is aquablation?
Aquablation is a minimally invasive, robot-guided procedure. It treats benign prostatic hyperplasia (BPH), a non-cancerous growth of the prostate gland. The prostate is a gland around the urethra, the tube that carries urine out of the body. In BPH the enlarged prostate squeezes the urethra. That makes urination hard. Aquablation was developed in 2013 and FDA-approved in 2017. It uses a high-pressure water jet of salt water. The jet is heat-free and removes extra prostate tissue.
Symptoms
BPH causes urinary symptoms in older men. Common ones include urinating often, getting up at night, a weak stream, trouble starting, and not emptying the bladder fully.
Causes and who gets it
BPH is the most frequently diagnosed cause of blocked urine flow in men. It becomes more common as men get older. Leaving a blockage untreated can harm the kidneys.
How doctors diagnose it
Preparation includes a checkup before treatment. A digital rectal exam lets the doctor check the prostate. A symptom score form also helps plan care. No prostate tissue is removed for testing, so prostate cancer screening should be done first.
Treatment
Side effects are relatively mild. They include burning when you urinate, blood in the urine, pelvic discomfort, trouble urinating, and urinary tract infections. These problems are usually short-lived. Compared with other prostate surgeries, this one has very low rates of three problems. These are leaking urine, semen flowing backward, and erection trouble. It is not suitable for patients on active blood thinners or with uncorrected bleeding disorders.
Options range from watchful waiting to medicines and surgery. Surgery is a choice when drugs do not work well or cause side effects.
During aquablation, first an ultrasound probe placed in the rectum takes live images of the prostate. The urologist uses these images to map the area to treat. This protects the bladder neck. Then a robotic probe guided through the penis uses an unheated, high-pressure water jet. It removes extra tissue by following the mapped outline. The water jet part takes only a few minutes. The whole procedure takes less than an hour. Bleeding is stopped with an electric cauterizing tool. A soft tube called a catheter drains the urine afterward. The catheter can often be removed the next day. The procedure needs anesthesia, so many patients stay overnight in the hospital.
Tell your doctor about all medicines you take, especially blood thinners.
When to see a doctor
See a doctor if urinary symptoms get worse or do not improve with treatment. Call 911 or go to the emergency room if you cannot urinate at all, if bleeding is heavy or will not stop, or if you have trouble breathing, chest pain, or fainting. A sudden block in urine flow can be an emergency in men with an enlarged prostate.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. They can evaluate urinary symptoms, order tests, and refer you to a urologist. They can also support you before and after the procedure and help manage other health conditions, but they do not perform the procedure itself.
Common questions
How long does aquablation take?
The water jet part takes only 5 to 10 minutes. The entire procedure takes less than an hour. You will still need anesthesia, and many patients stay overnight in the hospital.
Does aquablation affect sexual function?
It can, but studies report very low rates of three problems compared with other prostate surgeries. These are erection trouble, semen flowing backward, and leaking urine.
Can any prostate size be treated?
Yes. Aquablation can be used in glands of any size, including very large ones of 150 grams or more. It works best for prostates of about 30 to 80 grams.
Who performs aquablation?
A urologist performs aquablation in a hospital. The urologist controls a robotic system. It needs anesthesia, and many patients stay overnight.
Sources
- NCBI Bookshelf - Benign Prostatic Hyperplasia (StatPearls)
- NCBI Bookshelf - Obstructive Uropathy (StatPearls)
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
