Taiwan’s Chi Mei Medical Center Introduces AI-Assisted Water-Jet Prostate Surgery
TAINAN, Taiwan — A major medical center in southern Taiwan is bringing artificial intelligence and robotic automation into prostate surgery, offering men with benign prostate enlargement a minimally invasive option that uses a high-pressure water jet instead of conventional heat-based cutting.
Chi Mei Medical Center has introduced Aquablation, an advanced treatment for benign prostatic hyperplasia (BPH), combining real-time imaging, individualized treatment planning, AI-assisted automation and a non-heated water jet to remove excess prostate tissue.
The hospital says it is the first medical institution in southern Taiwan to introduce the minimally invasive prostate water-jet procedure, giving patients another option when medications or other treatments no longer adequately control symptoms.
AI maps the prostate before treatment
The technology does not mean an AI system independently decides how to operate on a patient.
Instead, doctors first use cystoscopy and transrectal ultrasound (TRUS) to obtain real-time information about the prostate's size, shape and important anatomical structures.
The treatment plan is then customized for the individual patient. Once the physician has established which areas should be removed and which structures should be preserved, the system uses automated control and a robotic arm to carry out the planned water-jet treatment.
That “plan first, execute second” approach is one of the major differences between Aquablation and more traditional procedures, according to Chi Mei urologist Tseng Wen-hsin.
No heat: How Aquablation works
Unlike traditional electrosurgical techniques and some laser procedures, Aquablation does not rely on thermal energy to remove excess prostate tissue.
Instead, it uses a high-velocity water jet to ablate the targeted tissue.
Doctors use imaging to guide the treatment and help avoid important surrounding structures. Because the procedure is a tissue-removing treatment, the removed tissue can also be sent for pathological examination.
For men worried about the potential effects of prostate surgery on urinary control and sexual function, that distinction is particularly important.
The symptoms many men ignore
BPH is common as men age, but symptoms can sometimes be dismissed as simply part of getting older.
Frequent urination, waking repeatedly at night to urinate and a weaker or thinner urine stream can all be warning signs of prostate enlargement.
When severe BPH is left untreated, urinary retention can occur and, in serious cases, bladder or kidney function can be affected.
Doctors at Chi Mei say they are also seeing greater willingness among younger men to seek treatment when urinary symptoms begin affecting sleep and daily life. Liberty Times reported that the hospital has observed an increase in patients under 50 seeking treatment for BPH-related symptoms.
What clinical research says about Aquablation
Chi Mei physicians cited data from the WATER and WATER II clinical studies, which included patients with prostate volumes of roughly 30 to 150 mL.
According to the hospital's presentation of the research, the automated tissue-removal portion of the Aquablation procedure averaged approximately 5.8 minutes, with treatment time less affected by increasing prostate size than some conventional approaches.
The hospital also cited comparative data showing rates of retrograde ejaculation, erectile dysfunction and urinary incontinence below 1% in the material it presented.
However, that figure should not be interpreted as a guarantee for every patient.
Outcomes can vary according to prostate anatomy, patient characteristics, baseline health and the specific surgical technique used. The reports themselves stress that treatment decisions require individual assessment by a urologist.
Why preserving function matters
For many men considering prostate surgery, the question is no longer simply whether urinary symptoms can be improved.
They also want to know what happens to their quality of life afterward.
Concerns about urinary incontinence, erectile function and retrograde ejaculation can lead some patients to postpone treatment even when BPH symptoms are disrupting sleep and everyday activities. Chi Mei says Aquablation provides another minimally invasive option aimed at addressing the enlarged tissue while taking preservation of surrounding structures and function into account.
Still, there is no single prostate procedure that is appropriate for every patient. The choice depends on factors including prostate size, symptoms, anatomy, medical history and the patient's priorities.
Aquablation is part of a wider shift toward minimally invasive treatment
Chi Mei's move comes as prostate treatment continues to expand beyond traditional transurethral resection of the prostate, commonly known as TURP.
Other minimally invasive approaches are also being used in Taiwan. Chi Mei's urology team, for example, has previously reported clinical experience with water-vapor thermal therapy, another minimally invasive treatment for BPH. The Taiwan Urological Association notes that water-vapor therapy has been incorporated into treatment options for appropriately selected patients.
The difference is that Aquablation uses a water jet to remove tissue, while water-vapor therapy uses thermal energy.
Chi Mei already has an established AI medical infrastructure
The prostate procedure is also part of a larger push by Chi Mei to incorporate artificial intelligence into clinical medicine.
The hospital's Smart Healthcare Center says it was established in 2019 and has developed AI and big-data applications across areas including critical care, anesthesia, pediatrics and obstetrics, nutrition and dialysis.
The center says its newer AI initiatives include generative-AI applications designed to support doctors, nurses, pharmacists and other healthcare workers.
Chi Mei's urology department has also developed a long history of minimally invasive and robotic surgery.
The procedure comes with a significant price tag
The new technology is not simply a routine replacement for existing prostate surgery.
According to Liberty Times, Aquablation is currently offered on a self-pay basis at Chi Mei and costs about NT$270,000.
The report also said only three hospitals in Taiwan had introduced the technology at the time of publication.
That means access and cost could remain important considerations even as the technology becomes more widely available.
A promising tool—not a replacement for doctors
The most important takeaway from Chi Mei's new procedure may be less about “AI performing surgery” and more about AI-assisted precision within a physician-led operation.
The doctor remains responsible for evaluating the patient, interpreting imaging, designing the treatment plan and deciding whether Aquablation is appropriate.
The automated system then helps execute that predetermined plan.
For men struggling with frequent urination, nighttime trips to the bathroom or a weakening urine stream, the development could provide another treatment option—but it also highlights why patients should seek a proper urological evaluation rather than assuming symptoms are simply a normal consequence of aging.
As AI, robotics and real-time imaging move deeper into the operating room, Taiwan's latest prostate-surgery development points toward a bigger question: how much of tomorrow's surgery will be planned by humans—and how much will be precisely executed by machines?