Reasons to overthrow TURP: bring on Aquablation

Iman Sadri, Adel Arezki, Félix Couture, David Dan Nguyen, Russell Schwartz, Ahmed S. Zakaria, Dean Elterman, Enrique Rijo, Vincent Misrai, Thorsten Bach, Claus G. Roehrborn, Kevin C. Zorn

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Purpose: In this review, we will discuss the state of the literature regarding Aquablation, its limitations, and opportunities for its application in the treatment of benign prostatic enlargement (BPE). Methods: A comprehensive review of original research on Aquablation was conducted. Articles related to transurethral resection of the prostate, holmium laser enucleation of the prostate, greenlight photoselective vaporization of the prostate, and simple prostatectomy were reviewed for discussion. Results: For small–medium prostates (30–80 mL), Aquablation’s main advantages include better ejaculatory function and similar functional outcomes compared to TURP. For large prostates (80–150 mL), Aquablation demonstrates shorter operative time and superior ejaculatory function when compared to simple prostatectomy, HoLEP, and Greenlight PVP. In addition, Aquablation displays shorter hospital stays than simple prostatectomy. The integration of software programming and semi-automatic technology increases the reproducibility of the procedure and helps standardize overall outcomes, while also accelerating the learning curve. Its ability to preserve antegrade ejaculation makes Aquablation a very compelling option for sexually active patients. However cost and postoperative bleeding risks remain a concern. Conclusion: The current evidence suggests that Aquablation is a safe and effective alternative for BPE for small to large prostates. Further prospective clinical trials, with comparisons to other BPE modalities, and data from longer follow-up periods are still required.

Original languageEnglish (US)
Pages (from-to)2291-2299
Number of pages9
JournalWorld journal of urology
Issue number7
StatePublished - Jul 2021


  • Aquablation
  • BPE
  • BPH
  • LUTS
  • Surgery

ASJC Scopus subject areas

  • Urology


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