Aquablation 3D ultrasound prostate mapping AI treatment
The AQUABEAM Robotic System uses AI-guided ultrasound mapping and a high-velocity waterjet to remove obstructing prostate tissue with robotic precision — no heat, no electricity, no manual estimation. Equivalent symptom relief to TURP. Ejaculation preserved in 92% of patients vs. ~35% with TURP.
Aquablation (AQUABEAM Robotic System, PROCEPT BioRobotics) delivers TURP-equivalent BPH symptom relief while preserving ejaculation in 92% of patients, compared to ~35% for standard TURP. The AI maps your specific prostate before the robot cuts — no two ablations are identical because no two prostates are identical. Seomyeon L Urology is Busan's only PROCEPT-certified facility. Procedure is same-day; average 1-day catheter; desk work in 1–2 weeks.
The procedure has four phases, all controlled by the AQUABEAM robotic system with the surgeon setting parameters and monitoring in real-time:
A transrectal ultrasound probe creates a precise 3D map of your specific prostate — its shape, size, zones, and the critical structures to protect (neurovascular bundles responsible for ejaculation, external urethral sphincter for continence). This map is what makes Aquablation different: the treatment plan is built around your anatomy, not an average.
Dr. Kim reviews the ultrasound map on the AQUABEAM console and defines the ablation zone — precisely where prostate tissue is to be removed, with safety margins around structures to protect. The AI confirms the plan geometry. This step takes approximately 5–8 minutes.
The AQUABEAM delivers a precise, high-velocity saline waterjet under robotic control, ablating only the tissue within the pre-planned zone. No heat is generated — tissue is removed by mechanical disruption, not thermal damage. This is why thermal injury to the ejaculatory ducts (the primary cause of TURP retrograde ejaculation) does not occur. Ablation phase: 4–8 minutes.
Cystoscopy confirms the ablation result. Targeted haemostasis is performed on any bleeding points. A urinary catheter is placed for 1 day average (range 0–3 days). Most patients are discharged the same day or the following morning.
| Factor | Aquablation | TURP | UroLift | Rezum |
|---|---|---|---|---|
| Ejaculation preserved | 92% | ~35% | ~80% | ~82% |
| IPSS improvement | 14–17 pts | 12–16 pts | 11–14 pts | 10–14 pts |
| Prostate size limit | 30–150 mL | 30–80 mL | 30–80 mL | 30–80 mL |
| Procedure mechanism | Waterjet (no heat) | Electrosurgery | Mechanical lift | Steam ablation |
| Hospital stay | Same day / 1 night | 1–2 nights | Same day | Same day |
| Catheter duration | 0–3 days avg 1 | 1–3 days | 0–1 days | 2–7 days |
| Return to work (desk) | 1–2 weeks | 4–6 weeks | 1–2 weeks | 2–4 weeks |
| Large prostate capable | Yes (up to 150mL) | No (>80mL) | No | No |
| Available in Busan | Seomyeon L only | Multiple clinics | Multiple clinics | Multiple clinics |
Aquablation is not an experimental procedure. Its evidence base includes a Level 1 randomized controlled trial and multiple prospective registries. Dr. Kim presents these data at the consultation so you can make an informed decision.
The WATER trial (n=181, blinded sham-controlled RCT) compared Aquablation to TURP for BPH symptom relief and ejaculatory function at 12 months:
| Endpoint | Aquablation | TURP |
|---|---|---|
| IPSS reduction (pts) | 16.9 | 15.1 |
| Qmax improvement (mL/s) | +8.0 | +7.0 |
| Ejaculatory function preserved | 92% | 32% |
| Surgical success (primary endpoint) | 81.3% | 80.5% |
| Transfusion rate | 5.6% | 0% |
Source: Gilling et al., European Urology, 2019. The transfusion rate in Aquablation has been reduced in subsequent device iterations and surgical technique refinement.
WATER II studied Aquablation specifically in prostates 80–150mL — the population excluded from TURP and minimally invasive procedures:
| Endpoint | WATER II Result |
|---|---|
| IPSS reduction at 2yr | 16.2 pts |
| Qmax improvement | +10.7 mL/s |
| Surgical success | 87.5% |
| Ejaculation preserved | 89% |
| Reoperation rate at 2yr | 4.7% |
Source: Desai et al., European Urology Focus, 2021. Large-prostate results comparable to standard prostate cohort — Aquablation does not sacrifice efficacy for size.
Spinal or general anaesthesia. Ultrasound mapping (10 min), treatment planning (5–8 min), waterjet ablation (4–8 min), haemostasis and cystoscopy (10–15 min), catheter placement. Most patients to recovery room within 90 minutes. Same-day or 1-night stay depending on catheter drainage volume and patient preference. English discharge notes provided.
Average catheter duration is 1 day — shorter than TURP (1–3 days) and significantly shorter than Rezum (2–7 days). Catheter removal in clinic; voiding trial performed before discharge. Urgency and mild burning on urination expected for 5–10 days as prostatic urethra heals.
Urgency, frequency, and mild haematuria (blood-tinged urine) are expected in the first week — this is normal healing of the ablated prostatic urethra. Increase fluid intake to 2.5L/day; avoid caffeine and alcohol. No strenuous activity. Video check-in with Dr. Kim at day 5.
Most patients return to desk work and light activity at week 2. Urinary stream measurably improved vs. pre-op. IPSS score re-assessed. Long-haul flight cleared at week 2 for most patients after video assessment.
Sexual activity cleared at week 3–4. Ejaculation preserved — first ejaculation post-procedure confirms function before symptom resolution is complete in most patients. Full gym and physical work at week 4.
Final IPSS improvement plateaus at 8–12 weeks. Uroflowmetry re-measured. 12-month video review confirms sustained response. Published WATER trial 5-year data shows 95%+ durability at 5 years.
You are a good Aquablation candidate if:
Dr. Kim advises against Aquablation if:
Dr. Kim reviews these and responds with a candidacy assessment and fixed price quote by email within 24 hours — before you book travel.
The ejaculatory outcome data is from a Level 1 blinded RCT (WATER trial, published in European Urology 2019) — not from Seomyeon L Urology's marketing materials. The trial showed 92% ejaculation preservation for Aquablation vs. 32% for TURP, with equivalent symptom relief. The difference is mechanistic: TURP uses electrical current that thermally damages the ejaculatory ducts running through the prostate; Aquablation uses a waterjet at body temperature that does not generate heat. Dr. Kim presents the full WATER and WATER II trial data at consultation so you can read the primary research yourself.
Two reasons: cost and training. The AQUABEAM Robotic System is a capital-intensive device. PROCEPT BioRobotics requires facility certification (equipment standards, OR specifications) and surgeon-specific training and proctoring before certification is granted. Most urology clinics in Korea have not made this investment — the device requires dedicated OR infrastructure and a trained surgical team. Seomyeon L Urology completed facility certification and Dr. Kim completed PROCEPT proctored training in 2022. To our knowledge no other Busan clinic has received PROCEPT certification as of our last verification in early 2025.
We perform all standard BPH procedures. Dr. Kim selects the procedure that fits your prostate anatomy, size, and priorities — not the procedure that earns the highest margin. If your TRUS volume is 35mL and IPSS is 10, UroLift may be more appropriate than Aquablation. If you have a 100mL prostate and ejaculation is a priority, Aquablation is likely the right fit. The comparison page shows all available procedures side by side so you can understand the decision framework before the consultation.
Minimum 5–7 days for most foreign patients. Day 0: procedure (same-day or 1-night stay). Day 1–2: catheter removal, voiding trial, discharge. Days 3–5: monitoring at hotel or accommodation (video check-in with Dr. Kim). Day 5–7: medical clearance to fly short-haul. Long-haul flight (10+ hours) cleared at 2 weeks. We provide a specific itinerary in the booking confirmation email.
Aquablation at Seomyeon L Urology is priced at $4,800–$6,200 USD all-in (procedure, anaesthesia, AQUABEAM device use, catheter management, and 90-day video follow-up). This compares to $12,000–$20,000 in the US and £8,000–£14,000 in the UK for the same procedure. See the pricing page for the complete fee schedule. A fixed quote is confirmed for your specific case at the pre-consult assessment.
WATER trial: 92% ejaculation preserved vs 32% for TURP
Send your TRUS volume and IPSS score by email. Dr. Kim reviews and responds with a candidacy assessment and fixed price quote within 24 hours.
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