A surgeon affiliated with Harbin Clinic has performed the first robotic aquablation surgery in northwest Georgia at Atrium Health Floyd Medical Center, offering a new, less-invasive option for men suffering from an enlarged prostate (benign prostatic hyperplasia, BPH). This procedure employs real-time imaging and a heat-free waterjet to sculpt away excess prostate tissue—while helping preserve urinary function and sexual health.
The technique, known as aquablation therapy, is powered by the HYDROS Robotic System, which integrates ultrasound imaging with AI-assisted planning to guide a high-precision, waterjet ablation of tissue. Because there is no thermal energy involved, the procedure is considered gentler on surrounding structures. Surgeons can visually distinguish which tissue to remove and which to spare. According to Dr. Ken Jones, chief physician officer, this robotic procedure is part of the hospital’s efforts to expand surgical robotics for better patient outcomes.
Men with BPH commonly experience symptoms such as a sudden urge to urinate, increased frequency of urination, especially at night, and weak urine flow. It is estimated that about 50 % of men aged 51–60 have BPH, and many report a reduced quality of life as their symptoms worsen. If left untreated, BPH may lead to bladder or kidney damage, bladder stones, or long-term urinary retention and incontinence.
Dr. Robert Williams, a urologist at Harbin Clinic who performed the surgery, says aquablation offers “precision” that can help patients regain a normal lifestyle without worrying about common side effects like sexual dysfunction. Recovery from the procedure typically takes around one week.
Global Trends & Supporting Advances
This surgery in Georgia is part of a broader wave of adoption of aquablation and other advanced therapies for enlarged prostate. Hospitals across the U.S. and abroad are introducing or expanding such offerings:
At Sarasota Memorial Hospital in Florida, surgeons have begun using the HYDROS platform to deliver heat-free, AI-guided aquablation for men with BPH.
Mount Sinai in New York City became the first hospital in NYC to deploy the HYDROS system in treating enlarged prostates, emphasizing its role in preserving continence and sexual function.
The University of Alabama at Birmingham now offers the system, making it one of only two centers in the state with this capability.
In Mississippi, Singing River Health System recently introduced HYDROS-based aquablation—bringing the advanced therapy to a new region.
In Florida, AdventHealth Wesley Chapel now provides HYDROS-enabled aquablation to treat BPH using next-gen robotics.
Beyond aquablation, other minimally invasive methods are also seeing wider use. For example, Greenwich Hospital in Connecticut has recently performed its first HoLEP (Holmium Laser Enucleation of the Prostate) procedure, an established laser-based technique for BPH. Meanwhile, a relatively new method—prostate artery embolization (PAE)—is gaining traction. In East Florida, AdventHealth has announced PAE as an outpatient alternative, where small vessels feeding the prostate are blocked to induce shrinkage, avoiding the need for major surgery.
At the 2025 European Association of Urology (EAU) Congress, early results from the WATER III trial were presented. The findings suggest that aquablation provides similar symptom relief to laser procedures but with lower rates of retrograde ejaculation and incontinence—15 % vs. 77 % for ejaculation issues, and 9 % vs. 20 % for incontinence in patients with large prostates.
One particularly dramatic case from India underscores the potential of robotic surgery for extreme presentations of BPH: surgeons used a robot-assisted procedure to remove a prostate weighing 437 grams—over ten times the usual size—with minimal blood loss and a fast recovery.
Clinical Evidence & Considerations
Aquablation is increasingly supported by longer-term data. A meta-analysis of the WATER and WATER II trials (with follow-ups out to five years) showed durable symptom improvement and low retreatment rates. As noted in a Harvard review, aquablation can preserve normal ejaculatory function more often than traditional surgical options. One caveat is that because aquablation is non-thermal, there is a higher risk of prolonged bleeding, and patients may see blood in their urine for several weeks postoperatively.
Aquablation is especially appealing for men who prioritize sexual function, but not every patient is a candidate. The decision depends on prostate size, anatomy, symptom severity, comorbidities, and patient goals. Meanwhile, HoLEP remains a strong option for many, especially for very large prostates. PAE offers a non-surgical option that can be done outpatient, with quicker recovery, but its long-term durability is still under investigation.
As robotic and AI-assisted systems proliferate, treatments for enlarged prostate are becoming more personalized and less invasive. For patients weighing treatment options, it’s increasingly possible to find therapies that balance symptom relief, recovery time, and preservation of sexual and continence functions.
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