Aquablation vs. Traditional BPH SurgeryWhat's the Difference?
When it comes to treating an enlarged prostate, not all procedures are created equal. If your urologist has told you it's time to consider surgery, you're probably asking the same question most men ask: What are my options — and which one is best for me?
Two of the most discussed are traditional TURP (transurethral resection of the prostate) and Aquablation therapy. Here's an honest, straightforward comparison to help you make an informed decision.
A Quick Look at TURP
TURP has been the gold standard for BPH surgery for decades. In this procedure, a surgeon uses an electrical loop to physically scrape away prostate tissue while looking through a scope. It's effective — but it relies on the surgeon's manual skill, uses heat energy, and carries a well-documented risk of side effects, particularly around ejaculatory and sexual function.
How Aquablation Is Different
Aquablation was FDA-cleared in 2017 and represents a fundamentally different approach to BPH surgery. Rather than relying on a surgeon's steady hand or heat-based tools, Aquablation uses:
- A robotic system that executes the removal with mechanical precision.
- Real-time ultrasound + camera imaging to map the prostate before treatment begins.
- A heat-free, high-pressure waterjet that removes only the tissue outlined in the surgical plan.
Side-by-Side Comparison
| Factor | TURP | Aquablation |
|---|---|---|
| Technology | Electrical resection loop | Robotic waterjet |
| Heat used? | Yes | No |
| Precision | Surgeon-dependent | Robotically controlled |
| Prostate size limits | Limited for larger prostates | Any size (30–200+ grams) |
| Ejaculatory dysfunction risk | Higher | Lower |
| Erectile dysfunction risk | Low | Low |
| Urinary incontinence risk | Low | Low |
| Hospital stay | 1–2 days | ~1 day |
| Recovery time | 4–6 weeks | ~2–4 weeks |
What About Sexual Function?
This is where many men have the most questions — and the most concerns. Ejaculatory dysfunction (specifically retrograde ejaculation) is one of the most common side effects of traditional BPH surgeries, affecting a significant percentage of TURP patients.
Because Aquablation's surgical map is designed to identify and preserve the ejaculatory structures, clinical data consistently shows it carries a meaningfully lower risk of this outcome. For men who want to protect their sexual function, this difference matters.
Does Prostate Size Matter?
Yes — significantly. TURP and some other BPH procedures have practical limitations when the prostate is very large, sometimes requiring open or laparoscopic surgery in those cases. Aquablation has no such limitation. The robotic system is designed to treat prostates of all sizes, making it a viable option for men who might otherwise have been told they're not candidates for minimally invasive surgery.
So Which Is Right for You?
The honest answer: it depends on your anatomy, your health history, and your priorities. That's what a consultation is for. Aquablation deserves a serious look — especially if you:
- Want to minimize risk to sexual function
- Have a larger prostate
- Are concerned about long recovery times
- Have heard about Aquablation and want to understand if it fits your situation
Ready to Take the Next Step?
Call Dr. Tallman's office to schedule your consultation, or take the free BPH Symptom Assessment online.