For many men, sexual function is one of the deciding factors when choosing a BPH treatment. Traditional surgeries like TURP work, but they come with a well-documented risk of ejaculatory dysfunction that's hard to ignore. Aquablation was designed, in part, to do better. Here's what the evidence and the patient experience actually show.
How Aquablation Protects Sexual Function
Aquablation begins with a 3D surgical map built from real-time ultrasound and cystoscopic imaging. That map identifies, and instructs the robotic system to preserve, the structures responsible for ejaculation. The result is a procedure that removes the obstructing tissue while leaving the ejaculatory anatomy intact whenever feasible.
The Numbers
- Retrograde ejaculation: Single digits to low teens in published Aquablation trials vs. 60–90% for TURP.
- Erectile dysfunction: No meaningful change in most patients pre- vs. post-procedure.
- Orgasm sensation: Preserved in the vast majority of men.
What "Preserving Ejaculation" Actually Means
In retrograde ejaculation, semen travels backward into the bladder instead of being expelled. The orgasm sensation usually remains, but the visible ejaculate is reduced or absent. After TURP, this happens to most men. After Aquablation, it's an exception rather than the rule.
When Can You Resume Sex?
Most urologists clear patients at the 4–6 week mark. By then, the catheter is long gone, the urethra has healed, and risks of bleeding or discomfort are minimal.
What If I Already Have ED Before Surgery?
Aquablation is unlikely to worsen pre-existing erectile dysfunction, and in some men, eliminating BPH symptoms, and reducing the medications used to treat them, can actually improve sexual function and energy. Talk to your urologist about ED treatment in parallel; the two conversations belong together.
The Bottom Line
Among current BPH procedures, Aquablation offers one of the strongest profiles for preserving sexual function. For men who consider that a priority, and most do, it's a major reason the procedure is increasingly the recommended option.