Urology Reform Transforming Patient Care

Date published: 9 December 2025

This cutting-edge technology is already reducing waiting lists, improving patient outcomes and transforming lives, demonstrating how innovation can deliver faster, safer, and more effective care for men with enlarged prostates. The South Eastern Health and Social Care Trust (SEHSCT) is leading the regional service as part of a coordinated, system-wide approach to modernising elective care.

Health Minister Mike Nesbitt welcomed the progress, saying: “This is an excellent example of our health and social care system working together to deliver real progress for patients. The expansion of Aquablation surgery shows what is possible when clinical teams, commissioners and Trusts collaborate with a clear focus on improving outcomes and reducing waiting lists. This is exactly the type of innovation and best-practice reform set out in the Elective Care Framework.”

The transformation of bladder outlet obstruction (BOO) surgery responds to rising demand, increased waiting times and the need for modern, efficient and equitable services. Around 750 men each year require BOO surgery, making it one of the largest urology waiting list cohorts in Northern Ireland.

Aquablation is a minimally invasive, robot-assisted treatment that uses high-pressure water jets to precisely remove excess prostate tissue, reducing the risk of complications while enabling quicker recovery. It is particularly effective for men with larger prostates and those who previously had limited treatment options. The technology also supports reduced operating times, more efficient theatre lists and, in time, day-case procedures.

The first Aquablation procedure in Northern Ireland was carried out by SEHSCT in May 2025. By the end of December 2025, more than 76 men will have been treated, with extremely positive results. Complication rates remain low, and 96.9% of patients report an extremely positive experience.

Clinical Lead for Urology, Mr Brian Duggan, said: 

“This is a truly regional service built on strategic planning, clinical leadership and multidisciplinary teamwork. Aquablation is transforming outcomes for men with enlarged prostates, including those with large and complex glands. With more surgeons becoming accredited, the South Eastern Trust is rapidly scaling up capacity to ensure patients across Northern Ireland benefit from this innovation.”

Two urology surgeons are already fully trained in Aquablation, with two more in training. By 2026, four consultants within SEHSCT will be qualified to deliver the procedure, enabling increased throughput and the introduction of day-case surgery, bringing further reductions in waiting times and hospital stays.

Half of all patients treated to date have come from the Belfast Trust, 40% from the South Eastern Trust and 10% from other Trusts, demonstrating a genuinely regional service that delivers care based on clinical need rather than geography. The success of the service has also been recognised with the Aquablation Team named Hospital Team of the Year at the Chairman’s SET Stars awards.

Minister Nesbitt added: 

“By embedding best practice, investing in modern technology and strengthening regional collaboration, we are delivering long-term, sustainable reform. This is about transforming lives, restoring quality of life and ensuring all patients across Northern Ireland have timely access to modern, effective treatment.”

In 2026, the Trust will continue to develop and expand the regional service, including treating larger and more complex prostates, trialling day-case procedures and optimising long-term outcome monitoring. Regional collaboration through the urology network will remain at the core, ensuring equitable access to BOO surgery and a comprehensive suite of treatment options across Northern Ireland.

This work represents a significant step forward in delivering the Elective Care Framework’s ambitions to reduce waiting lists, modernise pathways and ensure the health system acts as one coordinated regional service.