Aquablation, a robotic water‐jet ablation therapy, has gained popularity as a surgical treatment for lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). Although it is associated with reduced complication rates and improved preservation of sexual function, its efficacy in complex cases, such as those involving large prostates or patients on immunosuppressive therapy, requires further evaluation. We report the case of a 67‐year‐old male on immunosuppressive therapy who developed bladder neck necrosis following Aquablation for a 90‐g prostate. Postoperative complications included persistent dysuria, incontinence, recurrent urinary tract infections, and pelvic pain. Subsequent management involved completion transurethral resection of the prostate and necrotic tissue, and multidisciplinary collaboration to optimize immunosuppressive therapy. The patient experienced significant symptom resolution following these interventions, highlighting the need for caution when selecting Aquablation for high‐risk patients. This case underscores the importance of thorough preoperative planning and adherence to perioperative guidelines to mitigate risks and improve outcomes in complex surgical cases.
Daher et al. (2026) studied this question.