Aquablation for Large ProstatesWhy Gland Size Doesn't Have to Mean Open Surgery
If your urologist told you your prostate is "too large" for a minimally invasive procedure, that advice may be a few years out of date. Prostate size has traditionally been the dividing line in BPH surgery — small glands got minimally invasive treatment, large glands got open surgery or lengthy laser enucleation. Aquablation changes that math.
Why Size Normally Matters
Heat-based procedures remove tissue gradually. The bigger the gland, the longer the operation, the more heat delivered, and the higher the risk of bleeding and complications. That's why prostates over 80cc were often routed to open simple prostatectomy or HoLEP.
Why Aquablation Scales
Aquablation removes tissue with a high-velocity waterjet along a surgeon-defined map. The resection is fast and consistent, so treating a 120cc gland doesn't take dramatically longer than treating a 50cc gland. There's no thermal injury, and the surgeon can see the entire treatment in real time on ultrasound.
What the Data Shows
- Large improvements in symptom scores and peak urinary flow in men with glands from 80cc to 150cc+
- Low rates of ejaculatory dysfunction compared with resective heat-based options
- Short hospital stays — typically a single overnight
- No abdominal incision, unlike simple prostatectomy
Questions to Ask
- What is my prostate volume, measured how?
- Do I have a median lobe?
- How many large-gland Aquablation cases have you performed?
- What are my alternatives and their trade-offs at my size?
A large prostate is a reason to seek an experienced surgeon — not a reason to accept open surgery by default.
Ready to Take the Next Step?
Call Dr. Tallman's office to schedule your consultation, or take the free BPH Symptom Assessment online.
Frequently Asked Questions
Can Aquablation treat a large prostate?
Yes. Aquablation is used successfully on prostates well above 80cc, including glands over 150cc, because the waterjet removes tissue at a consistent rate regardless of gland size.
Is Aquablation better than a simple prostatectomy for large prostates?
Aquablation avoids an abdominal incision, produces less blood loss, and involves a shorter hospital stay than open simple prostatectomy, while achieving comparable symptom relief in most patients.
How long does Aquablation take on a large prostate?
The waterjet resection itself typically takes only a few minutes, and total operative time stays under about an hour even for large glands — one of the key advantages over heat-based enucleation.