Aquablation therapy is an innovative, minimally invasive surgical treatment for men with benign prostate enlargement.
Using the power of water delivered with robotic precision, Aquablation offers an effective way to relieve urinary symptoms while minimising the risk of side effects associated with traditional prostate surgery. Mr Rahim Kaba played a pivotal role in launching the Aquablation in the West Midlands and conducted the inaugural case.
Benefits of Aquablation
Aquablation offers several advantages over traditional surgical treatments for enlarged prostate. Clinical studies have shown significant improvements in urinary symptoms, flow rates and quality of life following Aquablation therapy.
The procedure is designed to minimise the risk of erectile dysfunction and preserve ejaculation, which can be affected by other surgical techniques. It is effective for prostates of varying sizes, including larger prostates that may be challenging for other minimally invasive treatments.
Using a water-based approach reduces the risk of thermal injury to surrounding nerves and tissues, enhancing safety. Real-time imaging and robotic assistance allow a high level of precision tailored to each patient’s anatomy.
Aquablation therapy FAQs
Why is Aquablation therapy performed?
Benign prostate enlargement is a common condition in men as they age, leading to bothersome urinary symptoms. These can include a weak urine stream, difficulty starting urination, frequent or urgent need to pass urine, a feeling of incomplete bladder emptying and interrupted sleep due to night-time urination.
If lifestyle measures and medications are no longer effective, surgical treatment may be recommended. Aquablation therapy is designed to remove excess prostate tissue and restore normal urine flow while preserving sexual and urinary function.
How does Aquablation therapy work?
Aquablation therapy uses a robotic-assisted surgical system that combines real-time ultrasound imaging with a precise, high-velocity water jet to remove prostate tissue causing obstruction.
During the procedure Mr Kaba uses a camera (cystoscope) and ultrasound guidance to map the prostate in real-time. This mapping allows for customised treatment planning to target and remove only the necessary tissue while avoiding structures related to continence and sexual function.
A heat-free, high-pressure water jet is then used to remove the excess prostate tissue accurately. The procedure typically requires a short hospital stay, with most patients returning home within 24–48 hours.
Is Aquablation therapy right for you?
Mr Kaba will carry out a detailed assessment, including a discussion of your symptoms, medical history and prostate imaging, to determine if Aquablation therapy is appropriate for you. This treatment is an excellent option for men who wish to relieve their urinary symptoms effectively while preserving sexual function and minimising downtime.
If you would like to know more about Aquablation therapy, or other treatments for benign enlarged prostate, please get in touch to arrange a consultation.
How effective is Aquablation?
Aquablation is designed to relieve bladder outflow obstruction – when an enlarged prostate narrows the tube urine passes through, making it harder for the bladder to empty properly. It’s been studied in several large clinical trials with results followed for up to five years. One way researchers measure success is the International Prostate Symptom Score (IPSS), a simple questionnaire covering things like stream strength, how often you need to go, and getting up at night, scored from 0 (no symptoms) to 35 (severe). In the main trial, IPSS scores improved by an average of 15 points at five years, and Qmax – the speed of your urine flow – nearly doubled, up around 125%. In men with larger prostates (80–150ml), scores improved from an average of 22.6 before treatment to 6.8 at five years. These are average results from clinical trials rather than a guarantee for any individual, and your own outcome will depend on factors like your prostate size and bladder function.
*Effectiveness, durability and sexual function figures are drawn from the WATER and WATER II randomised clinical trials comparing Aquablation with traditional prostate surgery (TURP).
What are the possible risks and side effects?
As with any prostate procedure, Aquablation carries some risks. In the early days it’s common to notice blood in the urine, some burning or discomfort when passing urine, and needing to go more often or urgently – these usually settle as swelling goes down. Less commonly, there’s a risk of infection, heavier bleeding needing further treatment, difficulty passing urine, or in rare cases narrowing further down the urinary tract. Changes to ejaculation can also occur. No prostate treatment can guarantee your urinary or sexual function will be completely unaffected. Mr Kaba will talk through the risks and benefits most relevant to you before your procedure.
Will I need a catheter, and for how long?
Yes, you’ll wake up from the procedure with a catheter in place, which drains the bladder while your prostate begins to heal. In Mr Kaba’s practice, this is usually kept in place for between 7 to 10 days, after which you’ll come back for it to be removed and for a quick check – called a trial without catheter, or TWOC – to confirm you’re passing urine well on your own. Occasionally it needs to stay a little longer, which is simply about your individual healing rather than a fixed rule. You’ll be given clear instructions on catheter care before you leave the hospital.
What happens immediately after the procedure?
You’ll be monitored while you recover from the anaesthetic and while any bleeding settles — it’s normal for your urine to look blood-stained at first. Once you’re well enough, you’ll be discharged with clear guidance on your catheter, medication, activity and hydration, along with the warning signs to look out for.
What is recovery like in the weeks that follow?
Recovery tends to improve gradually rather than in a straight line. In the first few weeks it’s common to notice some urgency, frequency, mild burning, or ups and downs in your urine flow as things settle. Some men find their flow improves quite quickly, while bladder symptoms like urgency can take a little longer to fully calm down – particularly if your bladder had been working hard against the blockage for some time beforehand. It’s best not to judge your final result too early; symptoms should keep improving as healing continues.
How long can I expect blood in my urine?
Some blood in the urine, known as haematuria, is a normal part of healing after Aquablation. It’s usually most noticeable straight after surgery and becomes lighter as you recover, though it’s common for it to come and go for up to three months – your urine might be clear for a few days, then turn pink or blood-stained again, sometimes after more activity than usual. This can still be a normal part of healing. Do get in touch if bleeding becomes persistently heavy, you pass significant clots, you can’t pass urine at all, or you develop a fever, chills, or feel generally unwell.
When can I get back to exercise, sport and normal activities?
Walking and everyday activity are encouraged from early on in your recovery. It’s best to build back up to more strenuous exercise, heavy lifting or cycling gradually, as vigorous activity can trigger further bleeding while you’re still healing. There’s no single timetable that suits everyone – it depends on how your recovery is going, your job, whether you’re still experiencing bleeding, and your general health. Mr Kaba will guide you through this at your follow-up.
How soon can I resume sexual activity?
Most men can resume sexual activity once they’re feeling comfortable and any significant bleeding has settled. Recovery varies from person to person, so there’s no benefit in rushing it. If you’re still experiencing noticeable bleeding, discomfort, or other concerns, it’s worth waiting and having a chat with Mr Kaba first.
Does Aquablation affect sexual function long-term?
Preserving sexual function – particularly ejaculation – is one of the main reasons some men choose Aquablation. In the main clinical trial, around 7% of men experienced ejaculatory dysfunction after Aquablation, compared with 25% after traditional TURP surgery – so while Aquablation doesn’t remove the risk entirely, it does significantly reduce it. It’s worth noting ejaculation and erections are different things – the trials also looked at erectile function, though Aquablation isn’t designed to treat erectile dysfunction itself. Individual results can’t be guaranteed, so if preserving ejaculation matters to you, do mention this to Mr Kaba so it can be factored into your treatment plan.
How long do the benefits of Aquablation last?
Clinical studies show the benefits of Aquablation are durable, with improvements holding up to at least five years so far. In men with larger prostates, over 96% remained free from needing further BPH surgery at the five-year mark. No prostate treatment can promise you’ll never need medication or another procedure in future, but the five-year evidence is reassuring, and researchers continue to follow patients for longer-term results.
What are the alternatives to Aquablation for an enlarged prostate?
Aquablation is one of several treatment options for benign prostatic hyperplasia, or BPH – a non-cancerous enlargement of the prostate – and it isn’t automatically the right choice for everyone. Depending on your symptoms, prostate size, bladder function and priorities, other options include lifestyle changes and medication, minimally invasive treatments like UroLift or Rezūm, Prostate Artery Embolisation, or surgical options such as TURP, GreenLight laser treatment, or enucleation procedures like HoLEP. These differ in how much tissue is removed, the size of the prostate they suit, how quickly symptoms improve, recovery time, durability, and effects on ejaculation – your consultation is about finding the right balance for you.
Mr Rahim Kaba
Mr Rahim Kaba is a highly skilled Consultant Urological Surgeon practicing at Nuffield Heath Warwickshire Hospital in Leamington Spa. He also serves as an Honorary Clinical Lecturer at Warwick Medical School within the South Warwickshire NHS Foundation Trust (SWFT).
Mr Kaba treats urinary infections, male urinary/prostatic symptoms, PSA/prostate cancer investigations, haematuria, female incontinence, impotence, penile, and testicular issues.
He specialises in lower urinary tract dysfunction, offering advanced minimally invasive treatments such as REZUM, Urolift, conventional bipolar TURP, and Aquablation for men with lower urinary tract dysfunction in the West Midlands. He played a pivotal role in launching the Aquablation in the West Midlands and conducted the inaugural case.
