Aquablation® Therapy for Enlarged Prostate (BPH)

Aquablation therapy removes the prostate tissue that blocks urine flow with a robotically controlled waterjet, guided by live ultrasound, and without heat. Dr. Edward Gheiler performs Aquablation regularly at Jackson North Medical Center for men whose enlarged prostate (benign prostatic hyperplasia) is causing a weak stream, frequent or night-time urination, or incomplete emptying.

How it works

The procedure is done through the urethra, with no incision, under anesthesia. Dr. Gheiler first maps your prostate with ultrasound and a camera and marks exactly what to remove and what to protect, including the area that controls ejaculation. The robotic system then removes the marked tissue with the waterjet according to that plan.

What the published studies show

In a randomized, double-blind trial of 181 men with prostates of 30 to 80 millilitres, symptom relief at five years was similar to traditional transurethral resection (a 15.1-point improvement versus 13.2; the difference was not statistically significant). Loss of ejaculation related to the procedure, counted at three months, was less common with Aquablation: 7 percent versus 25 percent. ^[1]
In a separate study of 101 men with larger prostates, 80 to 150 millilitres, the average symptom score fell from 22.6 to 6.8 at five years, and an estimated 96.3 percent were free of a second procedure for the enlarged prostate at five years. This study had no comparison group. ^[2]

These are results from published trials, not Dr. Gheiler’s own figures, and individual results vary.

Is it right for you?

Aquablation can treat a wide range of prostate sizes, including large prostates. It is one of several options; Dr. Gheiler also performs GreenLight laser therapy and Rezūm water vapor therapy, and he will tell you which one fits your prostate, your medications and your priorities. See the overview of enlarged-prostate treatment.

This page is patient education and does not provide a diagnosis or individualized treatment recommendation. Results vary from patient to patient. Talk to your urologist about your specific situation.

Recovery with Dr. Gheiler

You will go home with a urinary catheter. In Dr. Gheiler’s practice the catheter stays in for five to seven days, which is longer than many published descriptions; it is his protocol for every prostate procedure.
You stay in the hospital overnight for observation and go home the next day. It is an outpatient observation procedure, not a hospital admission.
Bleeding is the main risk in the first days and weeks.
The manufacturer’s safety information lists the most common side effects as mild and temporary: pain or difficulty urinating, pelvic discomfort, blood in the urine, trouble emptying the bladder, a frequent or urgent need to urinate, and bladder or urinary tract infection. ^[3]
Other risks include ejaculatory or erectile dysfunction, incontinence, urinary retention, narrowing of the urethra or bladder neck, injury to the urethra, bladder, prostate capsule or rectum, and the risks of anesthesia. Some of these can be serious and need further treatment. ^[3]
Burning, urgency and blood in the urine are common early and settle as the area heals.

Insurance and Medicare

Original Medicare in Florida covers Aquablation therapy for men who meet its medical criteria, which include a prostate between 30 and 150 millilitres and symptoms that continue despite at least three months of medication, or medication that cannot be taken or tolerated. ^[4] Medicare Advantage plans must follow Medicare’s coverage rules but may add network and prior-authorization steps; commercial plans set their own rules. Ask our office about your plan before scheduling.

Dr. Gheiler’s experience

Dr. Gheiler is a board-certified urologist who performs Aquablation therapy regularly. He completed the manufacturer’s Aquablation Therapy Training Program in April 2021 and again in November 2026 on the current HYDROS Robotic System, and he is listed in the manufacturer’s physician directory. Manufacturer training is not a certification; hospital privileges are granted by the hospital.

In June 2022, Local 10 News reported on Dr. Gheiler’s use of Aquablation therapy.

Frequently asked questions

Who performs Aquablation therapy for an enlarged prostate in the Miami area?

Dr. Edward Gheiler, a board-certified urologist based in Hialeah, performs Aquablation therapy regularly at Jackson North Medical Center.

Does Aquablation use heat?

No. The tissue is removed by a waterjet. A small amount of cautery may be used afterward to control bleeding.

How long does the catheter stay in after Aquablation?

In Dr. Gheiler's practice, five to seven days.

Do I stay in the hospital after Aquablation?

With Dr. Gheiler, yes, overnight for observation; you go home the next day.

See all FAQs →

References

Gilling PJ, Barber N, Bidair M, et al. Five-year outcomes for Aquablation therapy compared to TURP: results from a double-blind, randomized trial in men with LUTS due to BPH. Can J Urol. 2022;29(1):10960-10968. PMID 35150215.
Bhojani N, Bidair M, Kramolowsky E, et al. Aquablation Therapy in Large Prostates (80-150 mL) for Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia: Final WATER II 5-Year Clinical Trial Results. J Urol. 2023;210(1):143-153. doi:10.1097/JU.0000000000003483.
PROCEPT BioRobotics. Important Safety Information, HYDROS and AquaBeam Robotic Systems. procept-biorobotics.com/safety-info. Read November 13, 2026.
First Coast Service Options, Inc. Local Coverage Determination L38726, Transurethral Waterjet Ablation of the Prostate; revision effective April 6, 2025. Medicare Coverage Database. Read November 14, 2026.

Aquablation and HYDROS are trademarks of PROCEPT BioRobotics Corporation.

Tired of planning your day around bathrooms?

Ask whether Aquablation therapy is right for you. Request a consultation with Dr. Gheiler. English · Spanish · Hebrew.

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