Revenue Growth
Total revenue of $83.1 million in Q1 2026, representing 20% year‑over‑year growth and setting a strong start to the year.
Procedure Momentum
Approximately 12,200 U.S. procedures in Q1 2026, ~30% year‑over‑year growth, with management expecting procedure acceleration in the back half of 2026 (guidance of 60,000–64,000 U.S. procedures for FY2026, +39% to +48% vs 2025).
System Sales and Pricing Strength
Sold 49 U.S. Hydros systems (including 2 replacements) in Q1 with U.S. new system ASP of ~$485,000 — an all‑time high and a 14% increase vs Q4 2025; U.S. system revenue of $23.4 million (25% YoY growth). Management now expects remainder‑of‑year system pricing in the $450,000–$460,000 range.
Consumable (Handpiece) Performance
Handpiece ASP of ~$3,500 in Q1 (+5% vs Q4 2025; +10% YoY); handpieces sold represented ~95% of procedures in Q1, with total U.S. handpiece and consumables revenue of $43 million (+13% YoY). Management reiterates a ~1:1 handpiece:procedure ratio for the full year.
Gross Margin Improvement
Reported gross margin of 65% in Q1 2026 (vs 61% in Q4 2025 and 64% in Q1 2025). Company reiterates full‑year gross margin guidance of ~65% and expects modest sequential improvement through the year.
International Progress
International revenue of $11.1 million in Q1 (+25% YoY). Announced first international Hydros launch in the U.K. and sold 7 Hydros systems in the U.K. at ASPs above $400,000, with rapid NHS adoption noted.
Clinical and Regulatory Milestones
EU Association of Urology upgraded Aquablation to a strong recommendation as a surgical treatment for BPH (alternative to TURP) and the company received FDA clearance for second‑generation FirstAssist AI software — both bolster clinical credibility and product capability.
WATER IV Trial Progress
Patient enrollment nearing completion for the WATER IV study; management expects full enrollment by end of May and to present primary endpoint at AUA in spring 2027, which could meaningfully expand indications if positive.
Balance Sheet Strength
Cash, cash equivalents and restricted cash totaled $249 million as of March 31, 2026, providing runway to support commercial expansion and clinical programs.
Forward Guidance Reaffirmed
Reiterated FY2026 total revenue guidance of $390–$410 million (growth ~27%–33%), international revenue guidance of ~$50–51 million, and full‑year adjusted EBITDA loss expected to be $30 million to $17 million with positive EBITDA in Q4 2026 at both revenue range endpoints.