Best BPH procedures in 2024: Statistics show where Aquablation stands
- Team proudP
- Sep 1, 2025
- 4 min read
Updated: Jan 28
This article is based on insights shared by Alex Hughes, NP of Austin Urology Institute. Hughes is a Key Opinion Leader (KOL) for Procept Aquablation Therapy and has extensive experience guiding men with BPH.
Millions of Men, Limited Options
If you’re living with benign prostatic hyperplasia (BPH), you’re not alone. In the U.S. today:
34% of men (4.3 million) are simply watching and waiting.
64% (7.9 million) take daily medications.
Only 2% (about 248,000) go through a procedure.
Why Medications Fall Short
At first, medication can help. But over time, many men stop taking it.
It costs too much.
It’s inconvenient.
Side effects get in the way.
It doesn’t always work.
By the end of year one, only about 3 in 10 men are still on treatment. By year four, it drops to just 1 in 10.
Real-World Side Effects
Medications can improve urinary symptoms, but side effects are common and often lead men to stop treatment.
Alpha Blockers
5–15% dizziness or fatigue
3–5% erectile dysfunction
Up to 10% ejaculatory issues
Alex Hughes recalls a 76-year-old patient who fainted after his very first dose of an alpha blocker and had to be treated in the ER for head stitches.
5-Alpha Reductase Inhibitors (5ARI)
9% erectile dysfunction
7–8% ejaculatory problems
1–4% reduced libido
Can distort PSA levels, delaying prostate cancer detection
One young man on 5ARI for hair loss reported new ED and low libido.
Yes, these drugs can improve urinary scores —but the trade-offs are real.
How Diagnosis Should Feel Different
Hughes uses analogies that make sense. A TRUS or cystoscopy? That’s like popping the hood on a car to check the engine. Urinary retention? Think of it like a clogged toilet. Bladder wall changes? They look like the rings of a tree, showing years of strain. And recovery? It’s like cleaning up and recharging a battery.
When patients can see these comparisons, they get it. And once they understand, making decisions about their care becomes so much easier.
Hughes uses analogies:
Engine check = TRUS/cystoscopy let us “look under the hood”
Clogged toilet = urinary retention
Tree rings = bladder wall changes
Battery cleanup = what recovery feels like
When you can “see it,” you can understand it. And when you understand, decisions are easier.
Treatment Options in Plain English
Aquablation Therapy
Works for medium to large prostates (30–150g)
Robotic + ultrasound guidance = precise and minimally invasive
Preserves sexual and urinary function
Top choice at Austin Urology Institute
UroLift
Best for smaller prostates (≤60g)
Quick recovery, preserves sexual function
TURP
The “classic” surgery from the 1920s
Effective, but with longer recovery and higher risks
Rezūm
Uses steam to shrink prostate tissue
Works well in select cases
Curious how Aquablation compares with other treatments?
Check out our post:
Aquablation is emerging as one of the fastest-growing BPH procedures. In 2024, more than 33,000 Aquablation cases were performed in the U.S.—placing it just behind the long-standing gold standard, TURP (112,240 cases). While TURP still leads in total volume, Aquablation’s rapid rise highlights a strong shift toward newer, minimally invasive surgical options.
Why Aquablation Stands Out
Aquablation is different from the treatments that came before it. Instead of heat, steam, or blades, it uses a robotically controlled waterjet guided by real-time ultrasound. That means:
High precision: The surgeon can map out exactly which prostate tissue to remove. The robot then follows that plan, millimeter by millimeter.
Personalized treatment: Because it’s ultrasound-guided, the procedure adapts to each man’s unique prostate size and shape.
Gentle on surrounding structures: No burning or cutting means less risk of damaging the nerves that control sexual and urinary function.
Consistent outcomes: Clinical studies show durable symptom relief, even for men with larger prostates (up to 150g).
Patients often notice stronger flow and fewer trips to the bathroom soon after the procedure—without the long recovery or sexual side effects that older surgeries sometimes bring. As Hughes emphasizes:
The Bottom Line
If you’re tired of medications—or worried about their side effects—know that better options exist.
Aquablation represents a new era in BPH treatment: precise, minimally invasive, and designed to protect your quality of life.
The first step? Talk with your doctor, and start tracking your urinary health at home. The more you know, the better your choices will be.
And that’s where proudP can help. With just your smartphone, you can measure your urine flow at home—just like a uroflowmetry test in the clinic. The app automatically records your results, so you and your doctor can see real data, spot changes early, and decide together when it’s time to move beyond medications.
Staying informed starts in your own bathroom—and proudP makes it simple. Track your urinary
Quick FAQs
Does Aquablation affect sexual function?
Most men maintain both erectile and ejaculatory function—something traditional surgeries often compromise.
How long does recovery take?
Many men return to normal activities within days, not weeks.
Is Aquablation covered by insurance?
Coverage is expanding. Always check with your urologist and insurance provider.
