top of page
Search

How Long Do Aquablation Results Last?

Writer: Dr. Carlo Bravi
Dr. Carlo Bravi
1 hour ago
6 min read

Aquablation can provide sustained improvement in urinary symptoms and urinary flow. Clinical studies have reported benefits that remain evident five years after treatment, with relatively low rates of further surgery during that period. However, Aquablation should not be described as a permanent cure. The prostate can continue to change with age, and urinary symptoms can also be influenced by bladder function, medication and other medical conditions. Individual results therefore vary.


What Does Aquablation Treat?


Aquablation is used to treat urinary obstruction caused by benign prostate enlargement, also known as benign prostatic hyperplasia or BPH. During the procedure, real-time ultrasound imaging allows the surgeon to identify the prostate tissue causing obstruction. A robotically controlled, high-pressure waterjet then removes the selected tissue through the urethra without any external surgical incisions.


The objective is to create a clearer channel for urine to pass through the prostate. The procedure does not remove the entire prostate gland.


How Long Has Aquablation Been Studied?


Aquablation is newer than established operations such as TURP and HoLEP, so the available long-term evidence does not extend over as many decades. Nevertheless, prospective clinical studies now provide follow-up to five years. These studies have shown that improvements in urinary symptoms, urinary flow and quality of life can be maintained during this period in many patients. Five-year evidence is available for men with prostate volumes between 30 and 80 ml and for a separate group with larger prostates between 80 and 150 ml. The results are encouraging, although continued follow-up remains important because evidence beyond five years is more limited.


What Do the Five-Year Studies Show?


The WATER study compared Aquablation with TURP in men with urinary symptoms and prostate volumes between 30 and 80 ml. Improvements in symptom scores and urinary flow remained evident at five years. According to the European Association of Urology guidelines, surgical re-treatment within five years was reported in approximately 5.1% of patients treated with Aquablation in this study. Patients considering the two procedures can read a broader comparison of Aquablation versus TURP, including how the treatments differ in technique, recovery and potential side effects.


The WATER II study assessed Aquablation in men with larger prostates between 80 and 150 ml. At five years, improvements in urinary symptoms and flow were also maintained, and approximately 3% of participants had required further surgical treatment.


These percentages describe the patients included in clinical studies. They should not be interpreted as a guaranteed prediction for an individual patient because outcomes depend on anatomy, bladder function, surgical factors and the definition of retreatment used in each study.


Can the Prostate Grow Back After Aquablation?


Aquablation removes the prostate tissue selected during treatment, but it does not remove the entire prostate. The remaining benign prostate tissue can continue to change or enlarge over time. This does not mean that symptoms will necessarily return. Many patients continue to experience good urinary flow and symptom relief for years after treatment.


Further benign prostate growth can occur after any procedure that leaves prostate tissue in place, including TURP and HoLEP. The likelihood and timing of recurrent obstruction vary according to the original prostate anatomy, the amount of tissue removed and individual biological factors.


Three-stage diagram showing inner prostate tissue obstructing urine flow before Aquablation, its removal while the peripheral prostate remains, and possible inner tissue regrowth over time.

If symptoms recur, possible explanations include further prostate enlargement, scar tissue, bladder overactivity, reduced bladder muscle strength, urethral narrowing or another urinary condition. A return of symptoms therefore requires assessment rather than an assumption that the prostate has simply grown back.


Does Recurrent Urinary Frequency Mean the Treatment Has Failed?


Not necessarily. Urinary symptoms are not always caused exclusively by prostate obstruction.

Urgency, frequency and waking at night to urinate may persist or recur because the bladder has adapted to obstruction over many years. These symptoms can also be affected by fluid intake, caffeine, medication, diabetes, sleep disturbance, infection and age-related changes in bladder function.


Aquablation may successfully improve the obstruction while some bladder-related symptoms take longer to settle or require separate treatment.


What Is Meant by Retreatment?


Retreatment can mean different things in different studies. It may refer to restarting medication for urinary symptoms, undergoing an additional investigation or having another procedure.


Further surgical treatment after Aquablation may occasionally be required if symptoms remain troublesome or obstruction returns. The appropriate treatment depends on the cause and may not necessarily involve repeating Aquablation. Possible options can include medication, repeat endoscopic assessment, treatment of scar tissue or another prostate procedure. The decision should be based on updated symptoms, urinary-flow testing, residual urine measurement and prostate assessment.


What Factors May Influence How Long the Results Last?


The durability of treatment may be influenced by the original prostate size and anatomy, the amount and location of obstructing tissue, the presence of a median lobe, bladder function and the completeness of the treatment plan.


Other relevant factors include age, general health, previous prostate procedures, urinary retention, neurological conditions and whether symptoms are caused entirely by obstruction or partly by bladder dysfunction. This is why prostate size alone should not determine whether Aquablation is appropriate.


Prostate size is only one part of the decision. Learn more about who may be suitable for Aquablation and the assessment required before treatment.


How Will I Know Whether Aquablation Has Worked?


Success is assessed by more than one measurement. After recovery, your urologist may consider:

  • Improvement in urinary symptoms

  • Strength of urinary flow

  • Ability to empty the bladder

  • Reduced need for urinary medication

  • Improvement in sleep and daily activities

  • Overall satisfaction with treatment


Symptoms can fluctuate during the initial healing period. Temporary urgency, frequency, burning and blood in the urine do not necessarily indicate that the treatment has failed. Recovery is gradual and early urinary symptoms do not necessarily reflect the final outcome.


Learn more about what to expect during Aquablation recovery.


Is Follow-Up Required?


Follow-up arrangements vary according to the operation, recovery and individual clinical circumstances. A postoperative review may include discussion of symptoms, urinary flow measurement, assessment of residual urine and review of any tissue submitted for histological examination. Further investigations are not routinely required for every patient but may be recommended if recovery is slower than expected or symptoms persist.


Men should continue with appropriate PSA assessment and prostate-cancer evaluation when clinically indicated. Aquablation treats benign obstruction and is not a treatment for prostate cancer.


When Should I Seek Further Assessment?


You should request review if urinary symptoms fail to improve after the expected recovery period, gradually worsen again or become associated with repeated infections, inability to pass urine, increasing residual urine or visible blood in the urine.


Urgent medical advice is required for complete urinary retention, heavy or persistent bleeding, fever, severe pain or symptoms suggesting infection.


Frequently Asked Questions


Is Aquablation a permanent treatment?

Aquablation can produce durable improvement, but no prostate procedure can guarantee permanent symptom relief. The remaining prostate and the bladder can continue to change over time.

Five-year studies have reported relatively low surgical retreatment rates, including approximately 5.1% in the WATER trial and 3% in the WATER II large-prostate study. These figures cannot predict an individual patient’s result.

Further treatment may be possible if symptoms or obstruction return, but the appropriate option depends on the cause, prostate anatomy, previous surgery and bladder function. Repeat Aquablation is not automatically the preferred treatment.

No. Aquablation removes selected obstructing tissue but does not stop the biological process responsible for benign prostate enlargement.

Yes. Aquablation does not eliminate the entire prostate and does not prevent prostate cancer. PSA testing and other assessment may still be recommended according to age, symptoms and individual risk.


Considering Aquablation?


Dr Carlo Bravi offers private consultations in Northampton and private consultations in London for men considering Aquablation or comparing treatments for benign prostate enlargement. An individual assessment may include review of urinary symptoms, previous medication, prostate size and anatomy, urinary-flow results, bladder emptying and personal treatment priorities.


Learn more about Aquablation surgery and individual assessment or arrange a consultation to discuss whether the procedure may be appropriate for you.


Clinical Sources and Further Information



This article provides general information and does not replace an individual consultation or medical advice.

Comments

Commenting on this post isn't available anymore. Contact the site owner for more info.
Urobravi.com – private urology consultations in London and Northampton

Copyright © Dr Carlo Bravi 2026

bottom of page