Concierge urology · London
Aquablation for enlarged prostate (BPH) London.
NICE approved, robotic, heat free waterjet resection of the prostate with the PROCEPT BioRobotics AquaBeam. Preserves antegrade ejaculation in around 80 to 90% of men and works for prostates from 30 g up to 150 g.
What Aquablation is
Robotic, image guided, heat free waterjet resection.
A NICE approved robotic alternative to TURP that removes obstructing prostate tissue without heat.
Aquablation is a robotic surgical procedure that uses a high pressure, room temperature saline waterjet to resect the obstructing zone of the prostate in men with benign prostatic hyperplasia. The system is called AquaBeam and is made by PROCEPT BioRobotics. A transrectal ultrasound probe and a transurethral cystoscope give the surgeon a real time, multiplanar view of your prostate.
The consultant then draws the resection contour on screen, deliberately sparing the bladder neck, the ejaculatory ducts and the external sphincter. The robot delivers the ablation itself in around five minutes, following that plan exactly. Because it uses cold saline rather than heat, Aquablation avoids the thermal spread that damages the ejaculatory apparatus in TURP. NICE has recommended it for use in the NHS and it is now widely available in specialist UK private centres.
Who it is for
When Aquablation is the right step.
Situations where Aquablation is a reasonable choice within the wider set of BPH options.
-
Moderate to severe LUTS
IPSS 8 or above with a poor flow rate and troublesome symptoms from BPH.
-
Prostate 30 to 150 g
A wide gland size range, including large glands where TURP becomes technically harder.
-
Ejaculation matters to you
Sexually active men who want to protect antegrade ejaculation.
-
You prefer a robotic option
Patient preference over TURP, HoLEP or UroLift after a full discussion of the trade offs.
-
Failed or unwanted medication
Alpha blockers and 5 ARIs not enough, or side effects unacceptable.
-
Recurrent retention or bladder stones
Definitive treatment where medical therapy is no longer safe.
Ejaculatory function
Around 80 to 90% of men keep antegrade ejaculation.
The main clinical reason to choose Aquablation over TURP for men who care about ejaculation.
In published series, around 80 to 90% of men retain antegrade ejaculation after Aquablation. The equivalent figure for TURP is under 30%. The difference is anatomical: the AquaBeam plan can be drawn to spare the bladder neck and the small strip of tissue at the veru montanum where the ejaculatory ducts enter, whereas TURP resects across that zone by design.
Erectile function is separately preserved because there is no heat and no cautery near the neurovascular bundles that run alongside the prostate. For a younger, sexually active man, or for any man who values ejaculation, this is often the deciding factor. It should be balanced against the fact that TURP and HoLEP have decades of long term follow up while Aquablation now has published five year data from the WATER trial.
How the procedure works
30 to 45 minutes in theatre, one night in hospital.
A short, planned operation under general or spinal anaesthetic.
- 01
Anaesthetic
General or spinal anaesthetic in a CQC registered London theatre.
- 02
Imaging and planning
A transrectal ultrasound probe (TRUS) and a transurethral cystoscope map the prostate. Your consultant plans the resection contour on screen.
- 03
Robotic waterjet resection
PROCEPT BioRobotics AquaBeam delivers an automated, heat free, high pressure saline waterjet. The ablation itself takes around 5 minutes.
- 04
Haemostasis and catheter
Bleeding is controlled with focal cautery or a Foley catheter under tension. A three way catheter drains for 24 to 48 hours.
- 05
Recovery
Overnight stay for irrigation, catheter removal on the ward and discharge with a trial of void.
Outcomes
What the published data show.
Randomised and real world evidence from the WATER and WATER II trials and five year extensions.
-
IPSS
over 50%
Mean reduction in International Prostate Symptom Score at 12 months in the WATER and WATER II trials.
-
Qmax
2 to 3x
Improvement in maximum urinary flow rate at 12 months compared with baseline.
-
5 year durability
comparable to TURP
Retreatment rates at five years sit alongside TURP in published follow up.
-
Incontinence
under 1%
Persistent stress incontinence is uncommon in reported series.
Cost in London
£12,000 to £19,000 all inclusive.
Indicative self pay pricing across the main London units. Insurer covered pathways use the same providers.
In short
Aquablation in London: £12,000 to £19,000, one night in hospital.
The range reflects hospital, consultant fees, anaesthetic, one night stay, catheter care and the six week follow up. We share two or three firm quotes once we know your prostate size and any relevant history.
Where it is performed
London centres with AquaBeam.
A short list of the London units that have the robot on site and consultants credentialed to use it.
-
King's College Hospital Private
Denmark Hill. High volume tertiary urology unit with AquaBeam access.
-
HCA The Wellington Hospital
St John’s Wood. Long standing robotic urology programme.
-
HCA London Bridge Hospital
City centre unit with concierge urology pathways.
-
Cromwell Hospital (Bupa)
South Kensington. Bupa flagship with AquaBeam on the theatre list.
-
University College London Hospitals Private
Westmoreland Street. Academic urology partnership.
-
Hampshire Hospitals (private patient unit)
Just outside London for patients happy to travel a short distance.
Recovery
What to expect afterwards.
A predictable, quick recovery for most men. The honest bits are listed here.
-
Overnight stay
One night in hospital for bladder irrigation and observation.
-
Catheter 24 to 48 hours
Removed after a successful trial of void before discharge or at an early clinic visit.
-
Office work in 5 to 7 days
Most desk based patients return to work within a week.
-
No cycling or heavy lifting for 4 weeks
Protects the healing prostatic urethra and reduces bleeding risk.
-
Full activity by 6 weeks
Gym, running and sexual activity resume in a graded fashion.
-
Mild urgency and dysuria
Common in the first 2 to 6 weeks and settles as the raw surface heals.
Compared to alternatives
Aquablation vs TURP, HoLEP, UroLift and PAE.
A short, honest comparison to help you have the right conversation at consultation.
-
TURP
The historic gold standard. Excellent symptom relief but retrograde ejaculation in around 70% and a longer recovery.
-
HoLEP
Holmium laser enucleation. Superb for very large glands and durable, but retrograde ejaculation remains high.
-
UroLift
Prostatic urethral lift. No tissue resected and ejaculation preserved, but less durable in larger glands.
-
Prostate artery embolisation
Interventional radiology approach. Less invasive, useful for the medically frail, symptom relief is less predictable.
Frequently asked
Aquablation for BPH, honestly answered.
-
Is Aquablation a definitive treatment for BPH?
Yes. Aquablation removes obstructing prostate tissue in the same way TURP or HoLEP does, and published five year data show durability that sits alongside TURP with a low retreatment rate.
-
Is there a prostate size limit for Aquablation?
Aquablation is used for prostates from around 30 g up to 150 g. It is one of the few options that handles very large glands (80 g and above) in a single, short operation, where TURP becomes technically demanding.
-
Will Aquablation preserve ejaculation?
Around 80 to 90% of men retain antegrade ejaculation after Aquablation because the robotic plan spares the bladder neck and ejaculatory ducts. TURP preserves ejaculation in under 30% of men.
-
Is Aquablation covered by private medical insurance?
Bupa, AXA, Vitality, Aviva, WPA and Cigna all cover Aquablation with a specialist referral and a clear clinical indication. We handle preauthorisation and coding on your behalf.
-
How long is recovery after Aquablation?
One night in hospital, catheter for 24 to 48 hours, office work within 5 to 7 days, no cycling or heavy lifting for 4 weeks and full activity by 6 weeks.
-
What is the retreatment rate after Aquablation?
Published five year data from the WATER trial show retreatment rates of around 4 to 5%, in line with TURP and lower than minimally invasive options such as UroLift.
Speak to a London urologist
Book Aquablation in London, with the right consultant.
We match you to a UK GMC registered urology consultant who performs Aquablation regularly, at a London centre that has the AquaBeam robot on site. Insurer preauthorisation handled.