How an Intense Jet of Water Can Relieve an Enlarged Prostate

Doctors have a newer method for treating an enlarged prostate, which can squeeze the urethra and cause urinary problems for men, especially as they age. The treatment, Aquablation, uses an intense jet of water to remove part of the prostate, relieving the pressure.

“Patients with very enlarged prostates traditionally have limited options, but in a properly selected patient, the outcomes of Aquablation are equivalent and sometimes superior to traditional surgeries,” says Emil Kheterpal, MD, a urologist who performs surgeries at UNC Rex Healthcare and worked on clinical trials for Aquablation, which was approved by the Food and Drug Administration in 2017.

Compared with other surgical methods for enlarged prostate, Aquablation is a quicker procedure with less time under anesthesia, a lower risk of side effects and typically a faster recovery.

If you are a man who makes frequent trips to the bathroom, or who has problems starting or stopping your flow of urine, you may have an enlarged prostate, known as benign prostatic hyperplasia, or BPH. Talk to your doctor to find out, because BPH usually does not resolve on its own and your problems could get worse as you get older.

BPH symptoms include:

  • A frequent or urgent need to urinate
  • Need to urinate during the night with increasing frequency
  • Difficulty starting to urinate
  • A weak stream, or a stream that starts and stops
  • Dribbling at the end of urination
  • Inability to completely empty the bladder

While BPH is uncommon in men younger than 40, it affects half of all men ages 51 to 60. It is the most common prostate problem for men over 50, affecting about 14 million in the United States. The prevalence increases with age; about 90 percent of men over 80 have BPH.

BPH is noncancerous, but some of its symptoms are similar to early symptoms of prostate cancer. Men 50 and older should be screened for prostate cancer each year; men at high risk should start earlier.

Treatment Options for Benign Prostatic Hyperplasia

Men with BPH might find relief with treatment options that include medication and surgery. Your doctor might first prescribe medicine that slows the hormone production that affects prostate growth or a medicine that relaxes the muscle in the prostate.

A nonsurgical treatment called prostatic artery embolization, or PAE, works by blocking blood flow to the prostate, causing some of the prostate tissue to die and be absorbed by the body.

The most common surgical option is transurethral resection of the prostate (TURP). In this procedure, your doctor inserts special instruments through the urethra that remove pieces of the enlarged prostate.

Other procedures use electrical, light or heat energy to destroy part of the prostate.

Dr. Kheterpal says Aquablation may cause fewer side effects, such as ejaculatory dysfunction, than other surgical procedures.

Aquablation makes surgery much more efficient, Dr. Kheterpal says. “You can turn a three-hour surgery into a 45-minute surgery.”

One Man’s Experience with Aquablation

Lawrence Jones, 67, couldn’t make it from his home in Clayton, North Carolina, to his brother-in-law’s house in Ahoskie‚—a trip of about 130 miles—without stopping at least once to go to the bathroom. He would get up about five times a night to go pee but never felt like he was completely emptying his bladder, because of his BPH.

“I would get up and go,” he says, “but before I could fall back asleep, I felt like I had to go again.”

Jones heard about Aquablation from a friend in California.

“He’s a medical engineer and was on the team that developed this procedure,” he says. “When I started having symptoms, I called him. He told me that Dr. Kheterpal had one of the machines. I went and took care of business.”

Jones says he had his surgery on a Monday in February 2021 and was in the hospital overnight. He had a urinary catheter until that Friday (four days later).

“That was uncomfortable,” he says, “but it was worth the discomfort for the results I got. It was not unbearable by any means.”

He still gets up in the night, but not as often, he says.

He would recommend Aquablation to any other men who are diagnosed with BPH.

“It helped tremendously,” Jones says. “Now, I can make it from here to Ahoskie without stopping, no problem. It’s a world of difference.”

If you have symptoms of BPH or have questions about it, talk to your doctor. If you need a doctor, find one near you.