Aquablation of the prostate: single-center results of a non-selected, consecutive patient cohort
Aquablation of the prostate using the AquaBeam™ system promises equivalent functional outcomes, reduced learning curve, and improved sexual function compared to transurethral prostate resection as shown in prospective randomized trials. This prospective cohort study aims to evaluate if published results can be transferred into the clinical routine in a non-selected patient collective.
This study includes all patients treated between September 2017 and June 2018 with Aquablation of the prostate. Patients have been evaluated prospectively for the perioperative course and early follow-up. Besides voiding parameter and symptom score, TRUS-volume change, ejaculatory function, and adverse events have been recorded.
118 consecutive patients have been treated in the given time. Aquablation could be carried out successfully in all patients. IPSS, QoL, Qmax, and PVR improved significantly after the procedure and continued to improve during 3-month follow-up. Mean OR time was 20 min, TRUS volume decreased by 65%, and 73% of the patients retained antegrade ejaculation. Thirteen adverse events (> Clavien-Dindo I) occurred in 10 patients.
The surgical ablation of the prostate using Aquablation achieved significant and immediate improvement of functional voiding parameters Qmax and PVR as well as symptomatic improvement of IPSS and QoL. Aquablation seems to be safe and effective with a low perioperative complication profile even in a non-selected group of patients.
KeywordsBPH BPO Aquablation AquaBeam Waterjet
TB protocol and project development, data analysis, manuscript writing. GG manuscript writing and editing, data analysis. AB interpretation of data, critical revision of the manuscript. CF interpretation of data, critical revision of the manuscript. FGS interpretation of data, critical revision of the manuscript. TRWH interpretation of data, manuscript editing. CN interpretation of data, critical revision of the manuscript. MR interpretation of data, critical revision of the manuscript. CMS interpretation of data, critical revision of the manuscript. LT interpretation of data, critical revision of the manuscript. JJR interpretation of data, critical revision of the manuscript. EL interpretation of data, critical revision of the manuscript
Compliance with ethical standards
Conflict of interest
TB: Advisory, speakers honoraries, trial participation, meeting participation: R. Wolf, PROCEPT Biorobotics, Boston Scientific.
TRWH: Company consultant, advisory, patent, royalties, speakers honoraries Karl Storz, LISALaser, Advisory, speakers honoraries, travel grants, Boston Scientific Advisory, speakers honoraries.
Other authors declare that they have no conflict of interest and nothing to declare in regards with this manuscript.
This is a series of consecutive patients treated with in clinical routine. The study was approved by IRB and local ethics committee. All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
- 7.Lin Y, Wu X, Xu A, Herrmann TR et al (2016) Transurethral enucleation of the prostate versus transvesical open prostatectomy for large benign prostatic hyperplasia: a systematic review and meta-analysis of randomized controlled trials. World J Urol 34(9):1207–1219. https://doi.org/10.1007/s00345-015-1735-9 (Epub 2015 Dec 23) CrossRefPubMedGoogle Scholar
- 17.Gilling P, Barber N, Bidair M et al (2018) Water: a double-blind, randomized, controlled trial of aquablation® vs transurethral resection of the prostate in benign prostatic hyperplasia. J Urol 199(5):1252–1261. https://doi.org/10.1016/j.juro.2017.12.065 (Epub 2018 Jan 31) CrossRefPubMedGoogle Scholar
- 18.Cornu JN, Ahyai S, Bachmann A et al (2015) A systematic review and meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic obstruction: an update. Eur Urol 67(6):1066–1096. https://doi.org/10.1016/j.eururo.2014.06.017 (Epub 2014 Jun 25) CrossRefPubMedGoogle Scholar
- 23.Gilling P (2014) First-in-human clinical experience of a novel treatment for BPH: image guided robotically-assisted waterjet ablation of the prostate. J Endourol 28(Supplement):1Google Scholar