If your urologist told you your prostate is "too large" for a minimally invasive procedure, that advice may be a few years out of date. Prostate size has traditionally been the dividing line in BPH surgery, small glands got minimally invasive treatment, large glands got open surgery or lengthy laser enucleation. Aquablation changes that math.
Why Size Normally Matters
Heat-based procedures remove tissue gradually. The bigger the gland, the longer the operation, the more heat delivered, and the higher the risk of bleeding and complications. That's why prostates over 80cc were often routed to open simple prostatectomy or HoLEP.
Why Aquablation Scales
Aquablation removes tissue with a high-velocity waterjet along a surgeon-defined map. The resection is fast and consistent, so treating a 120cc gland doesn't take dramatically longer than treating a 50cc gland. There's no thermal injury, and the surgeon can see the entire treatment in real time on ultrasound.
What the Data Shows
- Large improvements in symptom scores and peak urinary flow in men with glands from 80cc to 150cc+
- Low rates of ejaculatory dysfunction compared with resective heat-based options
- Short hospital stays, typically a single overnight
- No abdominal incision, unlike simple prostatectomy
Questions to Ask
- What is my prostate volume, measured how?
- Do I have a median lobe?
- How many large-gland Aquablation cases have you performed?
- What are my alternatives and their trade-offs at my size?
A large prostate is a reason to seek an experienced surgeon, not a reason to accept open surgery by default.