Leading-edge surgery offers 'life-changing’ relief from symptoms of BPH, or enlarged prostate

A leading-edge, minimally invasive surgical treatment available at UChicago Medicine AdventHealth Bolingbrook is helping men reclaim their normal lifestyles after dealing with frequent urination, dribbling of urine and other symptoms of benign prostatic hyperplasia (BPH), or enlarged prostate.

“It’s nothing short of a miracle,” said Brian Falasz, 60, a retired technical writer who struggled with BPH for more than three years before undergoing the treatment at the Bolingbrook hospital. “After what I was struggling with, the results of the surgery have been life-changing.”

UChicago Medicine AdventHealth Bolingbrook is one of only a few Chicago-area hospitals that offer the treatment, which is known as Aquablation® therapy. The hospital also is one of only two hospitals in the Chicago area that have offered the procedure since 2019.

“We have been doing this procedure longer than any hospital in the southwest suburbs,” said Vibha Sabharwal, M.D., a board-certified urologist who has performed more than 100 Aquablations at the hospital, including Falasz’s procedure. “When we started, only one other hospital in the Chicago area offered it, and that hospital was up north. Since then, we have deepened our expertise in Aquablation, and its benefits compared with older surgical treatments for BPH are very clear. We have had patients from three hours away come here for this treatment.”

Many men delay BPH surgery because they are concerned about side effects. But clinical studies have shown that Aquablation patients have low rates of permanent complications such as incontinence, ejaculatory dysfunction and erectile dysfunction.

Sabharwal said most of her Aquablation patients have reported significant improvements similar to those experienced by Falasz. He used to get up five or six times each night to use the bathroom and needed to stop every 30 minutes to relieve himself during road trips. Today, he sleeps through the night, no longer feels exhausted during the day, and takes three-hour road trips without stopping. His other BPH symptoms, such as dribbling of urine, also have disappeared, and Aquablation did not affect his sexual function. The few side effects he had right after the procedure, such as blood in his urine and an urgent need to urinate, subsided quickly.

“When you have the procedure done, it’s literally liberating,” Falasz said. “It’s like flipping a switch – like night and day.”

A few months after Falasz underwent Aquablation in February 2024, he and his wife went on a two-week trip to Europe. This past February, they celebrated his 60^th birthday by taking a Hawaiian cruise. “I didn’t have any issues on either trip,” Falasz said. “It has been wonderful. It’s like being 35 again.”

The incisionless, robotic-assisted treatment involves accessing the prostate through the urethra and using ultrasound technology and a high-pressure water jet to ablate, or remove, a precise amount of prostate tissue. The procedure is performed in the hospital with the patient under anesthesia and takes about an hour. It normally requires an overnight stay and causes minimal side effects. Recovery time can range from three to six weeks, with BPH symptoms – and the need for BPH medications – gradually subsiding.

The biggest benefits of Aquablation compared with older BPH surgical treatments are its accuracy and the long-lasting relief it can provide without the need for additional procedures, Sabharwal said.

“You use the ultrasound at the beginning of the procedure to actually mark off the tissue you want to remove, and then you use the robot to vaporize that tissue with room-temperature water,” Sabharwal said. “Because you have the imaging modality assisting you, you can accurately remove a large amount of tissue in a short time, and that can provide long-lasting relief.”

Older BPH surgical treatments sometimes require staged procedures, “where you do some of it and come back and do more months later,” Sabharwal said. “With Aquablation, you can get rid of all the tissue at once. It has more finesse.”

The urethra runs through the prostate, and in men with BPH, the prostate constricts the urethra, impeding the flow of urine, Sabharwal said. “If you think of the prostate as an apple, what this surgery does is core the inside of the apple so the channel is open,” she said.

Aquablation offers an effective alternative for men with BPH who have not found relief through more-conservative therapies, Sabharwal said. “We don’t offer this procedure right off the bat,” she said. “It’s usually for men who already have been on medication for a while and still are having all the symptoms of BPH.”

For more information about Aquablation, contact UChicago Medicine AdventHealth Medical Group Urology at Call630-226-1436, or visit Aquablation | UChicago Medicine AdventHealth.