EAU Guidelines Upgrade Aquablation Therapy to Strong Surgical Recommendation for BPH Treatment
核心洞察
The European Association of Urology (EAU) has upgraded Aquablation therapy to a strong recommendation as a surgical treatment option for men with benign prostatic hyperplasia (BPH).
The guidelines now strongly recommend offering Aquablation therapy as an alternative to transurethral resection of the prostate (TURP) for men with moderate-to-severe urinary symptoms due to BPH.
This upgrade is particularly significant for patients interested in preserving ejaculatory function and reflects strong evidence quality from multiple clinical trials.
The European Association of Urology (EAU) has elevated Aquablation therapy to a strong surgical recommendation for treating benign prostatic hyperplasia (BPH), marking a significant milestone for PROCEPT BioRobotics' innovative treatment approach. The upgrade, announced in March 2026, positions Aquablation therapy as a preferred alternative to traditional surgical interventions for men suffering from moderate-to-severe urinary symptoms.
Clinical Evidence Drives Guideline Upgrade
The EAU guidelines, widely regarded as one of the most rigorous and influential clinical guideline frameworks in urology globally, now strongly recommend offering Aquablation therapy as an alternative to transurethral resection of the prostate (TURP) for men with moderate-to-severe urinary symptoms due to BPH. This recommendation is particularly emphasized for patients interested in preserving ejaculatory function.
The upgrade indicates strong evidence quality and a favorable balance between benefit, harm, and patient preference. The guidelines are supported by outcomes from multiple clinical trials on Aquablation therapy, including WATER, a randomized trial against TURP, and WATER II trials demonstrating durable improvements in urinary symptoms and preservation of sexual and urinary function.
"A strong recommendation from one of the most respected global guideline bodies reflects the strength of the clinical evidence supporting Aquablation therapy and reinforces its role as a modern surgical option for physicians seeking to deliver durable symptom relief while preserving quality-of-life outcomes that matter most to patients," said Evangelos Liatsikos, MD, PhD, Professor of Urology and Chairman of the Department of Urology at the University of Patras, Greece, and Chairman of the European School of Urology (ESU).
Expanding Treatment Options Across Prostate Anatomies
The guidelines now recognize evidence supporting Aquablation therapy across a broad range of prostate anatomies, including larger prostate glands. Additional evidence continues to emerge from recently published studies such as WATER III, a randomized trial against laser enucleation in large glands, further strengthening the therapy's clinical foundation.
Larry Wood, President and Chief Executive Officer of PROCEPT BioRobotics, emphasized the significance of this development: "The strength of the clinical evidence supporting Aquablation therapy continues to grow, and this guideline upgrade from the European Association of Urology represents an important milestone for Aquablation therapy."
AI-Enabled Technology Platform Launches Internationally
Concurrent with the guideline upgrade, PROCEPT BioRobotics announced the international expansion of the HYDROS Robotic System, the company's next-generation platform for delivering Aquablation therapy. HYDROS represents the first AI-enabled robotic platform designed specifically for the treatment of BPH with Aquablation therapy.
The system leverages AI-interpreted, real-time ultrasound imaging and advanced image-guided treatment planning, enabling surgeons to deliver personalized, anatomy-specific therapy with robotic precision and reproducibility. The platform is designed to support scalable adoption across care settings while maintaining consistent procedural execution.
"The HYDROS Robotic System brings AI-enabled, real-time ultrasound-guidance and robotic assisted treatment planning to NICE-recommended Aquablation therapy in the UK, supporting precise, anatomy-specific treatment," said Mr. Neil Barber, Consultant Urological Surgeon. "By combining surgeon judgement with robotic precision, Aquablation with HYDROS enables durable symptom relief and preservation of quality-of-life outcomes, including sexual and urinary function and meaningfully expands surgical choice for men living with BPH."
Addressing Unmet Clinical Needs
Aquablation therapy offers a complete solution for men living with BPH, with a robust body of clinical evidence demonstrating that the treatment delivers durable symptom relief while preserving sexual and urinary function. These outcomes are critically important to patients who often face difficult treatment decisions.
"Many men living with BPH remain on long-term medication or delay surgery because they are concerned about potential trade-offs between symptom relief and side effects," said Larry Wood. "The HYDROS Robotic System expands international access to a clinically validated, next-generation AI-enabled robotic solution that delivers durable symptom relief while preserving quality of life."
Growing International Recognition
Recognition from the EAU adds to growing international clinical validation for Aquablation therapy, including support from health technology assessment bodies such as the National Institute for Health and Care Excellence (NICE) in the United Kingdom supporting the routine use of Aquablation therapy within the NHS.
BPH is the most common prostate disease and impacts approximately 40 million men in the United States. PROCEPT BioRobotics has developed a significant and growing body of clinical evidence with approximately 250 peer-reviewed publications, supporting the benefits and clinical advantages of Aquablation therapy.
The company's technology represents the first and only ultrasound guided, robotic-assisted, heat-free waterjet for the treatment of BPH. The system's real-time ultrasound imaging provides surgeons with a multi-dimensional view of the prostate enabling personalized treatment planning tailored to each patient's unique anatomy, allowing surgeons to specify which areas of the prostate to remove while preserving the anatomy that controls erectile function, ejaculatory function and continence.