Aquablation vs. HoLEP: Free Yourself From Urinary Catheterisation

Home > Aquablation vs. HoLEP: Free Yourself From Urinary Catheterisation

If you have a urinary catheter and have been waiting for HoLEP surgery, have been struggling with frequent urges to urinate, or experiencing countless sleepless nights caused by an enlarged prostate, you are not alone. Benign Prostatic Hyperplasia (BPH) affects millions of Canadian men as they age – studies estimate that about one in four men over 50 experience moderate to severe symptoms, and the number rises to nearly half for men over 80.

While medications can provide initial relief, many men continue to face persistent symptoms or require additional procedures when drug therapy doesn’t suffice.

Luckily, you have treatment options available to you, so you can free yourself from urinary catheterisation. Advances in technology have led to minimally invasive procedures that can significantly improve symptoms with less downtime and fewer side effects than traditional surgery. Two of the most effective and widely discussed options today are Aquablation and HoLEP.

Both treatments aim to remove excess prostate tissue and restore normal urinary flow, but they vary in technique, technology, and patient experience. Let’s take a closer look at how each procedure works, their advantages and recovery experiences, and how to determine which one might be the best fit for you.

What is Aquablation?

Aquablation is a modern, minimally invasive treatment for BPH that uses a robot-guided waterjet to remove excess prostate tissue. It is designed to provide the precision of robotic surgery with the safety and effectiveness of traditional procedures and without the heat damage caused by lasers or cautery. Dr. Kevin Zorn, our world-class urologist at BPH Canada, is currently the only doctor in Canada to offer this procedure.

How Aquablation Works

Aquablation combines real-time imaging with robotic precision. During the procedure:

Our surgeon uses ultrasound and a camera to map the exact size and shape of the prostate.
A robotic system then directs a high-pressure saline waterjet to precisely remove the obstructing tissue.
Since the system relies on imaging and computer guidance, the surgeon can plan the treatment area in advance and execute it with exceptional accuracy.

Key Advantages of Aquablation

Aquablation’s combination of technology and precision offers several benefits:

Preserves sexual function: Because there is no heat that is used, there is a lower risk of damaging nerves that control ejaculation.
Predictable outcomes: The robotic guidance allows consistent results across different surgeons and prostate sizes.
Short learning curve: Unlike laser techniques, Aquablation can be mastered relatively quickly by urologists.
Minimally invasive: Most patients only need an overnight hospital stay and return to normal activities within days.

Additionally, studies have shown that Aquablation can lead to better long-term symptom relief and lower complication rates compared to other traditional BPH treatments, as well as significantly lower rates of ejaculatory dysfunction. These results support the idea that Aquablation is the right choice for men with medium-sized prostates.

Aquablation’s Recovery and Side Effects

Recovery after Aquablation is typically smooth and fast:

Typically, a one-night stay at the hospital is required for monitoring.
A temporary catheter is used for 1 to 2 days in order for the urine to drain.
Common short-term side effects include mild burning with urination, small amounts of blood in the urine, or temporary urgency, all of which usually resolve within a few weeks.
Most men experience significant symptom relief and improved urine flow within a month.

Since Aquablation minimizes heat exposure, men who undergo this procedure experience less dry orgasms and incontinence compared to those who undergo other traditional procedures.

What is HoLEP?

HoLEP, which is short for Holmium Laser Enucleation of the Prostate, is a minimally invasive laser treatment used to treat BPH. This procedure involves using a laser to remove the entire portion of the prostate that can block the flow of urine.

How HoLEP Works

HoLEP uses a holmium laser to precisely cut and remove the enlarged prostate tissue that blocks urine flow. Here is what happens during the procedure:

Our surgeon inserts a thin scope (a resectoscope) through the urethra. No external incision is required.
Using the holmium laser, our surgeon carefully separates the enlarged tissue from the outer area of the prostate.
The freed tissue is then pushed into the bladder and removed using a morcellator, which grinds it into small pieces for extraction.
The removed tissue can be analyzed in a lab, where our doctors will check for any signs of prostate cancer or other abnormalities.

Key Advantages of HoLEP

Some major benefits of HoLEP include:

Works for prostates of any size: It is especially effective for very large glands.
Long-term durability: It has low re-operation rates, with excellent outcomes lasting over 10 years.
Minimal bleeding: The laser seals blood vessels as it cuts, making it safer for patients on blood thinners.
Comprehensive tissue removal: Since the entire enlarged tissue is removed, recurrence is rare.

HoLEP’s Recovery and Side Effects

Similarly to Aquablation, recovery from HoLEP is relatively quick:

The procedure typically involves a 1 to 2-night hospital stay for observation.
A catheter is kept in place for 1 to 2 days to help with urine flow.
Common short-term side effects include temporary burning with urination, mild bleeding, or urgency for a few weeks.
Some men do experience dry orgasms or temporary urinary incontinence, though these often improve with time.
Most patients notice a dramatic improvement in their urinary flow and quality of life within the first month.

Which BPH Relief Procedure is Right For Me?

Choosing between Aquablation and HoLEP for relief from urinary catheterisation depends on several personal factors. Both are safe, effective, and minimally invasive options for treating BPH, but the best choice ultimately comes down to your prostate size, health profile, and lifestyle priorities.

Prostate Size and Anatomy: While Aquablation tends to be ideal for medium to large prostate sizes, HoLEP is effective for all prostate sizes, including very large glands. If your prostate is especially large, our urologist may lean toward HoLEP for complete tissue removal and a more effective solution.
Sexual Function and Quality of Life: Aquablation has a lower risk of retrograde ejaculation (dry orgasms) compared to HoLEP. If maintaining natural ejaculation is an important factor for you, Aquablation may be the better choice.
Recovery and Lifestyle Considerations: Both procedures offer a fast recovery, but there are some minor differences. For instance, Aquablation has a slightly shorter hospital stay of only one night, and most patients can resume normal activities within a few days. On the other hand, HoLEP may involve a 1 to 2-night stay and a few more days of post-procedure recovery. If returning to work or daily routines quickly is a top priority, Aquablation may offer a small advantage.

Both Aquablation and HoLEP are highly effective in relieving men of their BPH symptoms and urinary catheterisation, restoring urinary flow, and improving their quality of life. The best procedure for you really depends on your own unique goals.

Ultimately, the most important step is an open discussion with your urologist, where you review your prostate size, lifestyle goals, and treatment expectations together. This will help you determine which option will give you the best long-term outcome.

BPH Treatments and Relief from Urinary Catheterisation at BPH Canada

If you currently have a urinary catheter and are waiting to get HoLEP surgery, wait no longer. Options are available to you, and that includes Aquablation at BPH Canada. Aquablation stands out for its robotic precision, shorter recovery, and lower risk of sexual side effects, making it an excellent option for men who value preserving ejaculation and want a quick return to normal life.

Ultimately, the best procedure is the one that aligns with your goals and health profile. Talk to our world-class urologist about your symptoms, prostate size, and lifestyle priorities. Together, you can decide which approach offers the greatest comfort, confidence, and quality of life in the years to come. Book a consultation today and free yourself from urinary catheterisation.