As benign prostatic hyperplasia (BPH) is an age-related process, growing interest in surgical management for elderly men has emerged. Recently, Aquablation was approved for treatment of BPH associated lower urinary tract symptoms (LUTS) and utilizes robotic ultrasound guided surgeon-controlled waterjet ablation. We assessed the differences in functional and surgical outcomes between elderly and young men undergoing Aquablation for BPH/LUTS.
We retrospectively assessed prospectively collected data from the WATER I (NCT02505919) and WATER II (NCT03123250) clinical trials reporting safety and efficacy of Aquablation in the treatment of LUTS/BPH in men 45-80 years with a prostate between 30 and 80 cc, and 80 cc and 150 cc, respectively. Men ≥ 65 years were defined as elderly and men < 65 years as young.
Of 217 patients included, 83 (38.2%) were young and 134 (61.8%) were elderly. Mean age (SD) was 59.3 (± 3.4) years and 71.2 (± 4.2) years for young and elderly men, respectively. At 3 years of follow-up compared to baseline, elderly men showed similar reductions in total IPSS (7.68 points vs 7.12 points, p > 0.05) and similar increases in Qmax (20.6 mL/s vs 19.3 mL/s, p > 0.05) compared to young men. The ejaculatory dysfunction rate was similar for both cohorts (12.0% vs 9.7%, p > 0.05). Elderly men experienced similar annual retreatment rates compared to young men (1.5% vs 0.8% p > 0.05).
Elderly men undergoing Aquablation have similar functional and surgical outcomes as young men. Elderly patient BPH surgical counseling should, therefore, consider Aquablation as a treatment option for LUTS/BPH.
World journal of urology. 2022 Aug 30 [Epub ahead of print]
Brendan L Raizenne, David Bouhadana, Kevin C Zorn, Neil Barber, Peter Gilling, Steven Kaplan, Gopal Badlani, Bilal Chughtai, Dean Elterman, Naeem Bhojani
Division of Urology, Centre Hospitalier de l'Université de Montréal, 900 St. Denis, Montréal, QC, H2X 0A9, Canada. ., Faculty of Medicine, Mcgill University, Montréal, QC, Canada., Division of Urology, Centre Hospitalier de l'Université de Montréal, 900 St. Denis, Montréal, QC, H2X 0A9, Canada., Department of Urology, Frimley Park Hospital, Frimley, UK., Department of Urology, Bay of Plenty District Health Board Clinical School, Tauranga, New Zealand., Department of Urology, Mount Sinai Hospital, New York, NY, USA., Department of Urology, Wake Forest School of Medicine, Winston-Salem, NC, USA., Department of Urology, Weill Cornell Medical College/New York Presbyterian, New York, NY, USA., Division of Urology, University Health Network, University of Toronto, Toronto, ON, Canada.