Robust Procedure Growth Drives U.S. Momentum (Image Credits: Unsplash)
For patients grappling with benign prostatic hyperplasia, the rising number of robotic procedures offers a promising shift toward more precise treatments. PROCEPT BioRobotics Corporation delivered first-quarter 2026 results that exceeded revenue expectations, recording $83.1 million in sales, up 20 percent from the year-ago period.[1][2] Executives highlighted early gains from organizational changes, even as short-term disruptions occurred. The performance reassures stakeholders, from surgeons adopting the technology to investors eyeing a path to positive earnings.
Robust Procedure Growth Drives U.S. Momentum
Aquablation therapy users completed approximately 12,200 procedures in the United States during the quarter, reflecting 30 percent year-over-year growth.[1] This uptick stemmed from an expanded install base of 765 systems, a 40 percent increase from the prior year. Handpiece and consumable revenue reached $43 million, up 13 percent, while the company sold 49 HYDROS systems at an average price near $485,000 – its highest ever.
U.S. revenue totaled $72 million, a 19 percent rise, underscoring broad-based capital equipment demand rather than reliance on a few large deals. Management noted that handpiece utilization hit 95 percent of procedures, with average selling prices climbing 10 percent year over year to about $3,500. These figures demonstrate steady adoption among urologists treating enlarged prostates.
Commercial Overhaul Yields Pricing Discipline
Over the past six months, PROCEPT implemented a commercial realignment, integrating sales and clinical teams into regional structures for greater accountability. A dedicated launch team now standardizes system activations to accelerate procedure ramps. CEO Larry Wood stated, “We have taken decisive actions to reset the organization by sharpening our focus on operational excellence, accountability, and commercial discipline.”[1]
This shift produced immediate pricing gains but caused transitional procedure softness in the quarter. Still, U.S. system average selling prices rose 14 percent from the prior quarter. International revenue climbed 25 percent to $11.1 million, boosted by the HYDROS launch in the United Kingdom, where seven systems sold above $400,000 each. Executives expect these changes to fuel stronger second-half execution.
Financial Guidance Holds Firm with Added Conviction
PROCEPT reaffirmed its full-year 2026 outlook, projecting $390 million to $410 million in revenue – implying 27 to 33 percent growth. U.S. procedures should range from 60,000 to 64,000, a 39 to 48 percent increase.[2] Second-quarter revenue guidance sits at $91 million to $95 million. Gross margins held at 65 percent, matching the annual target despite tariff headwinds of $5 million to $6 million.
- Total revenue: $390M–$410M
- U.S. procedures: 60,000–64,000
- Gross margin: ~65%
- Adjusted EBITDA loss: $30M–$17M (positive in Q4)
CFO Kevin Waters expressed heightened confidence in these targets following the quarter’s results. The company anticipates system prices of $450,000 to $460,000 for the rest of the year, pushing the full-year average toward $460,000.
Clinical Milestones Bolster Long-Term Outlook
Regulatory progress supported the quarter’s momentum. The European Association of Urology elevated Aquablation to a strong recommendation as an alternative to traditional surgery for moderate-to-severe lower urinary tract symptoms. The FDA also cleared second-generation FirstAssist AI software, enhancing personalized treatment planning on the HYDROS platform.
Enrollment in the WATER IV prostate cancer trial advanced ahead of schedule, set to complete by late May, with primary results slated for 2027. These developments position Aquablation for broader urology applications, potentially expanding beyond BPH. Internationally, the U.K. rollout signals early steps in global scaling.
PROCEPT ended the quarter with $249 million in cash, ample runway for investments in innovation and commercial expansion. While operating losses widened to $31.6 million due to higher expenses, gross margin expansion and cost controls pave the way for positive adjusted EBITDA in the fourth quarter. For surgeons and patients, this trajectory promises wider access to robotic precision; for shareholders, it underscores a maturing business nearing profitability amid a competitive medtech landscape.
