# A Narrative Review of Robotic Aquablation in Benign Prostatic Hyperplasia Care: Where We Are Now

## TL;DR

Robotic Aquablation is a promising new treatment for BPH that improves urinary symptoms while preserving sexual function better than traditional surgery.

## Contribution

This paper reviews the current evidence for robotic Aquablation as a novel, image-guided therapy for BPH.

## Key findings

- Aquablation provides durable improvements in urinary outcomes comparable to TURP.
- It preserves sexual function with significantly lower rates of ejaculatory dysfunction.
- More formal meta-analyses and systematic reviews are needed to consolidate findings.

## Abstract

Benign prostatic hyperplasia (BPH) is a condition causing lower urinary tract symptoms (LUTS) that impair men's health and quality of life for years. The well-established surgical treatments, like transurethral resection of the prostate (TURP), may pose risks of thermal injury and subsequent sexual dysfunction. This narrative review summarizes the current evidence for robotic Aquablation, a novel, image-guided therapy for BPH. Aquablation utilizes a heat-free, high-velocity saline jet, robotically controlled under real-time ultrasound, to precisely resect tissue while preserving crucial collagenous structures like the bladder neck and ejaculatory ducts, so this may preserve the functional outcomes. Clinical trials and prospective studies have consistently demonstrated that Aquablation provides significant and durable improvements in urinary outcomes, including International Prostate Symptom Score (IPSS) and peak flow rate (Qmax), comparable to TURP. Its primary advantage is the superior preservation of sexual function, with significantly lower rates of ejaculatory dysfunction compared to standard procedures. Furthermore, a more formal meta-analysis and systematic review incorporating newer studies is desired.