To evaluate functional outcomes following Aquablation in various prostate volume and anatomical subgroups.
A meta-analysis with individual patient data undergoing Aquablation therapy from four prospective, global, clinical studies that have been conducted with Aquablation; WATER, WATER II, FRANCAIS WATER and OPEN WATER.
Australia, Canada, Lebanon, Germany, New Zealand, UK and the USA.
425 men with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) with 1-year follow-up.
Aquablation therapy is an ultrasound guided, robotically executed waterjet ablative procedure for the prostate.
The analyses focus International Prostate Symptom Score (IPSS), uroflowmetry, postoperative Incontinence Severity Index (ISI) and surgical retreatment.
425 men with prostates ranging in size from 20 to 150 mL underwent Aquablation therapy. The outcomes from the seven questions in the IPSS questionnaire were grouped by the following; prostates <100 mL, prostates ≥100 mL, prostate anatomy with an obstructive median lobe identifed by imaging, and prostate anatomy without an obstructive median lobe. Regardless of subgroup, all outcomes are consistent and demonstrate a significant improvement from baseline. Specifically, improvements in frequency, urgency and nocturia demonstrated bladder function improvement. Patients entering treatment with severe incontinence, ISI score >4, and regardless of prostate size, showed a reduction in incontinence during patient follow-up. Surgical retreatment due to BPH symptoms occurred in 0.7% (95% CI 0.1%-2.0%).
Across a variety of prostate anatomies, Aquablation therapy showed remarkable functional improvements following the index procedure. Additionally, men with moderate to severe LUTS/BPH and overactive bladder resulting in urge incontinence showed a reduction in incontinence symptoms postprocedure.
BMJ surgery, interventions, & health technologies. 2021 Jun 23*** epublish ***
Dean Elterman, Peter Gilling, Claus Roehrborn, Neil Barber, Vincent Misrai, Kevin C Zorn, Naeem Bhojani, Alexis Te, Mitch Humphreys, Steven Kaplan, Mihir Desai, Thorsten Bach
Surgery, University of Toronto, Toronto, Ontario, Canada., Urology, Tauranga Hospital, Tauranga, New Zealand., Urology, The University of Texas Southwestern Medical Center, Dallas, Texas, USA., Urology, Frimley Health NHS Foundation Trust, Frimley, Surrey, UK., Urology, Clinique Pasteur, Toulouse, France., University of Montreal Hospital Center, Universite de Montreal, Montreal, Québec, Canada., Urology, Weill Cornell Medical College, New York, New York, USA., Urology, Mayo Clinic Arizona, Scottsdale, Arizona, USA., Urology, Mount Sinai Medical Center, New York, New York, USA., Urology, University of Southern California, Los Angeles, California, USA., Urology, Asklepios Westklinikum Hamburg, Hamburg, Hamburg, Germany.