Aquablation Shows a Favorable Long-Term Safety Profile in the Treatment of Benign Prostatic Hyperplasia

Aquablation has emerged as a safe long-term treatment option for men with benign prostatic hyperplasia (BPH) who are hoping to preserve sexual function and minimize their risk for post-surgical complications, according to new results presented at the 2026 Annual Meeting of the American Urological Association in Washington, D.C. Data collected over a 3-year period at the Sheba Medical Center in Tel Aviv, Israel showed that patients undergoing Aquablation procedures for BPH have a low risk of severe long-term complications.

Over the past decade, Aquablation has continued to gain traction due to its precision and potential to preserve sexual function, which distinguish it from conventional BPH surgical options. The high reproducibility of the procedure and the AI-powered, real-time imaging have been shown to minimize adverse events and improve surgical outcomes. A systematic review of randomized controlled trials and real-world studies conducted through June 2025 previously showed that Aquablation had a favorable safety profile across different prostate sizes, with complication rates that were typically lower than or comparable to those associated with conventional surgical techniques [Triantafyllou P et al. Medicina (Kaunas) 2025; 61(12):2076]. 

Researchers in Tel Aviv devised a prospective study to take a closer look at the frequency and clinical significance of late complications occurring months after Aquablation. The ongoing study has, so far, enrolled 200 patients with a median age of 69.6 years who underwent Aquablation for moderate to severe BPH symptoms between 2022 and 2024 at the Sheba Medical Center. More than a third of those patients required catheterization for a median duration of 12 weeks before undergoing Aquablation. All participants were monitored for at least 12 months, with an average follow-up period of 13.48 months to date. 

The preliminary results showed that most complications occurred within the first 18 months after surgery. Late complications, documented in 11.5% of participants at a median of 28 weeks, included urethral strictures, mild urinary incontinence, bladder-neck contractures, and residual adenoma. Overall, less than 10% of the adverse events were severe (classified as Clavien-Dindo grade 3 and higher). Six of the 17 patients who experienced severe complications required reoperation at a median of 57 weeks. Most strictures were treated effectively with one-time, office-based cystoscopic urethral dilation. 

“The procedure demonstrated a highly favorable safety profile,” said presenting author Rinat Lasmanovich, MD, a urology resident at the Sheba Medical Center and a researcher at Tel Aviv University. While Lasmanovich and colleagues will continue to gather data from the patients that have not yet reached 36 months of follow-up, the early results suggest that Aquablation is a safe treatment option for older men with moderate-to-severe urinary symptoms related to BPH. Future analyses may also stratify complication rates based on prostate size. “We did not check this specific parameter in this study,” Lasmanovich noted. “Yet, the assumption is that the larger the prostate, the longer the surgery duration. With longer surgery [duration], the risk for stricture is rising. We hope to publish the results on large prostates in the near future.”