When a man undergoes Aquablation for an enlarged prostate, he expects relief from symptoms that have been disrupting his daily life.
Aquablation is marketed as a minimally invasive option for benign prostatic hyperplasia (BPH) that preserves sexual function while reducing urinary symptoms.
But like any surgery, it carries real risks, and when something goes wrong, patients are left wondering whether the procedure was performed correctly and whether they were truly informed about what could happen.
Prior results do not guarantee a similar outcome.
What Is Aquablation and Why Is It Used
Aquablation is an FDA-cleared, Class II medical device procedure for treating BPH, the medical term for an enlarged prostate. As men age, the prostate often grows larger, pressing on the urethra and causing frequent urination, a weak stream, difficulty starting urination, and a sense of incomplete bladder emptying.
The procedure uses a robotic system, the AQUABEAM Robotic System, guided by real-time ultrasound imaging to direct a high-velocity saline waterjet that removes excess prostate tissue blocking the urinary passage.
Unlike traditional transurethral resection of the prostate (TURP), which uses an electrical loop to cut tissue, or laser procedures that vaporize it, Aquablation relies on the force of saline solution to ablate tissue while the surgeon controls the treatment zone using imaging.
Aquablation still requires anesthesia, instruments passed through the urethra, and removal of prostate tissue, all of which carry inherent risk.
What Complications Can Occur After Aquablation
Documented Aquablation complications include:
Bleeding, sometimes requiring blood transfusion, particularly in patients on blood thinners or with bleeding disorders
Urinary retention, requiring a catheter, or urinary incontinence that may resolve over time or, less often, persist
Urinary tract infection, especially when a catheter remains in place for an extended period
Sexual side effects, including erectile dysfunction or retrograde ejaculation
Urethral stricture or bladder neck contracture, a narrowing that can require additional procedures to correct
Rectal injury, a rare but serious complication, since the rectal wall sits directly behind the prostate
A 2025 peer-reviewed review of real-world Aquablation outcomes found that serious (Clavien-Dindo grade 3b) complications occurred in about 9 percent of patients, mostly related to bleeding, with occasional cases of rectal perforation or urethral stricture.
Within that same review, one 330-patient study found urinary tract infection was the most common early complication at about 11 percent and bleeding requiring transfusion occurred in about 3 percent of patients, while ejaculatory dysfunction affected roughly 10 percent of Aquablation patients compared to roughly 36 percent of patients after traditional TURP.
Was There a Problem With the Device Itself
Most Aquablation complications relate to how a specific procedure was performed or explained, not a flaw in the equipment. That said, FDA records show a Class II recall of the AQUABEAM Handpiece, a single-use component of the system, in 2021.
The recall addressed a risk that the scope tube tip could detach from the handpiece, which could require an extra procedure to retrieve the tip or replace the handpiece mid-surgery.
It was a narrow, component-specific issue, not a finding that the overall device is unsafe, and it doesn’t mean every complication traces back to it.
A claim that the device itself was defectively designed or manufactured is a separate product liability question from a claim about how your surgeon performed the procedure or what you were told beforehand, and it’s far less common.
What Does Informed Consent Mean in New York
New York law requires physicians to disclose the material risks, benefits, and reasonable alternatives of a proposed treatment before you agree to it.
Under Public Health Law 2805-d, a physician must disclose what a reasonable practitioner would disclose under similar circumstances, including risks that are reasonably foreseeable and material to your decision, even if they’re rare, as long as they’re serious enough that a reasonable person would want to know about them.
For Aquablation, that discussion should have covered the risk of bleeding and transfusion, urinary retention or incontinence, sexual side effects, the risk of urethral stricture or bladder neck contracture, infection, and the rare but serious risk of rectal injury, along with reasonable alternatives.
Under PHL 2805-d, a claim based on lack of informed consent requires proof of three things:
The physician failed to disclose a material risk or alternative that a reasonable practitioner would have disclosed
A reasonably prudent person in your position would not have gone through with the procedure if properly informed
The undisclosed risk is what actually caused your injury
Signing a consent form doesn’t automatically defeat this kind of claim. A form listing risks in technical language, without real explanation or discussion, may not satisfy a physician’s duty, particularly if the discussion was rushed or your questions weren’t adequately answered.
Were You Told About the Alternatives to Aquablation
Part of informed consent is discussing reasonable alternatives. For BPH, the right choice depends on prostate size, overall health, and how much you prioritize preserving sexual function.
Option | How It Works | Worth Knowing |
|---|---|---|
Medication (alpha blockers, 5-alpha reductase inhibitors) | Relaxes prostate and bladder neck muscle, or shrinks the prostate over time | Most conservative option, avoids surgical risk entirely |
TURP | Electrical loop cuts and removes tissue | Long track record, effective for larger prostates, higher rate of retrograde ejaculation |
HoLEP or PVP (laser procedures) | Laser enucleates or vaporizes tissue | Can remove more tissue than some alternatives; more surgeon-dependent |
UroLift | Implants hold prostate lobes apart | Preserves ejaculatory function, generally not suited to larger prostates |
Rezum | Steam destroys excess tissue | Minimally invasive, also generally for smaller prostates |
If a surgeon presented Aquablation as the only option, or minimized the effectiveness of alternatives without a medical reason, that could point toward inadequate informed consent.
Can You Sue for a Complication After Aquablation in New York
New York generally requires proof of two things in a medical malpractice case, a departure from accepted medical practice, and evidence that the departure was a proximate cause of your injury.
A poor outcome alone isn’t enough. Depending on the facts, that departure might look like:
Negligent performance. The surgeon failed to exercise the skill and care a reasonably prudent surgeon would exercise, for example by misdirecting the waterjet, failing to control bleeding, or injuring structures outside the treatment zone.
Lack of informed consent. You weren’t told about a material risk or alternative, and that undisclosed risk is what caused your injury.
Poor patient selection. A reasonable surgeon would have recognized you weren’t a good candidate for Aquablation and would have recommended a different approach.
Evaluating any of these requires a qualified expert to review your operative report, imaging, and other records to determine whether the standard of care was met.
New York also requires expert medical testimony to support a malpractice claim, and your attorney must obtain a certificate of merit from a physician who believes there’s a reasonable basis for the case before the lawsuit can move forward.
Damages in these cases generally fall into a few categories: past and future medical expenses, lost wages, pain and suffering, and loss of enjoyment of life.
New York generally does not allow punitive damages in medical malpractice cases, except in narrow circumstances involving gross negligence or reckless conduct.
How Long Do You Have to File a Claim
New York’s statute of limitations for medical malpractice is two years and six months from the date of the malpractice, or from the end of continuous treatment for the same condition by the same provider, under CPLR 214-a.
There are narrow exceptions to this rule, but waiting too long can mean losing the right to bring a claim entirely, so it’s worth talking to an attorney as soon as you suspect something went wrong.
Before a malpractice lawsuit can proceed, your attorney needs a certificate of merit confirming that a physician found a reasonable basis for the claim. From there, both sides typically exchange records, take depositions, and consult expert witnesses before the case settles or goes to trial.
Frequently Asked Questions
Does signing a consent form before Aquablation prevent me from bringing a claim?
Not necessarily. A signed form is evidence that some disclosure occurred, but it doesn’t automatically defeat a claim. If the risks were listed only in technical language without real explanation, if the discussion was rushed, or if your specific questions weren’t answered, a court can still find that informed consent wasn’t properly obtained. What matters is the substance of the conversation, not just the signature.
Can I still have a claim if my surgeon says my complication is a known risk of the procedure?
Possibly. Being a “known risk” affects whether the complication itself proves negligence, but it doesn’t end the inquiry. If that known risk was never disclosed to you beforehand, you may have an informed consent claim. And even a recognized risk can still point to negligent performance if it happened in a way, or to a degree, that suggests a technical error rather than an unavoidable complication.
What if I was treated by a hospital’s urology team rather than one private surgeon?
Responsibility can extend beyond a single surgeon. Assistant surgeons, other members of the surgical team, and the hospital or surgical center itself may all be potential parties, depending on who made which decisions and what the records show. An attorney can help sort out who was actually responsible for the specific decision or action that led to your complication.
Is Aquablation itself defective, or is this about how it was performed?
These are different legal questions. A claim about how your specific procedure was performed, or what you were told beforehand, is a medical malpractice question. A claim that the device itself was defectively designed or manufactured would be a separate product liability question and is far less common. Most Aquablation complications relate to how the procedure was performed or explained, not a flaw in the equipment.
How soon after surgery do I need to notice a problem for a claim to still be possible?
There’s no fixed number of days, but New York’s standard malpractice deadline runs from the date of the procedure or the end of continuous treatment, not from when you first noticed a problem. That makes it important to act promptly once you recognize that your recovery isn’t going the way you were told to expect, rather than waiting to see if things improve on their own.
Summing It Up
A serious complication after Aquablation raises real questions: whether the procedure was performed correctly, whether you were a good candidate, and whether you understood the risks you were accepting.
If you believe you were harmed by a complication after Aquablation, Porter Law Group can review your records and help you understand your options. Call 833-PORTER9, email info@porterlawteam.com, or contact us online.
This article is for informational and educational purposes only. It is not a substitute for medical advice from a qualified healthcare provider or legal advice based on your specific circumstances.
Prior results do not guarantee a similar outcome.
