Aquablation: Powerful Relief for Big Prostate LUTS in BPH

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madman

Super Moderator
Aquablation, a treatment for benign prostatic hyperplasia, has demonstrated positive outcomes with low morbidity in large prostates (>80 mL). A study found significant and sustained improvements in patient symptoms, including a decrease in International Prostate Symptom Score and an increase in maximum urinary flow rate. Aquablation showed reproducible clinical outcomes and a low re-treatment rate at 5 years. While the study lacked a comparison group, previous trials showed similar results. Aquablation offers a viable option for men seeking to preserve continence, erectile function, and ejaculatory function.




Key Points:
  • The study reports 5-year safety and efficacy outcomes of the Aquablation procedure for treating symptomatic benign prostatic hyperplasia with large-volume prostate glands
  • 101 men with moderate to severe symptoms and prostate volumes between 80 and 150 mL underwent robotic-assisted Aquablation in a multicenter trial
  • The study successfully met its safety and efficacy goals at 3 months based on outcomes of transurethral resection typically performed in smaller prostates
  • Patient symptoms significantly improved with a decrease in International Prostate Symptom Score and an increase in maximum urinary flow rate
  • Regression analysis showed a 50% reduction in PSA levels
  • Aquablation demonstrated durable efficacy and low retreatment rates in men with large prostates (80-150 mL) at 5 years of follow-up
 

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Table 1. Baseline Demographics of the Initial WATER II Cohort and Those Available at 60 Months of Follow-up
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Figure 2. Longitudinal International Prostate Symptom Score (IPSS), IPSS quality of life (QOL), maximum urinary flow (Qmax), post-void residual (PVR), Male Sexual Health QuestionnaireeEjaculatory Dysfunction (MSHQ-EjD), and International Index of Erectile Function (IIEF-5) outcomes. CI indicates confidence interval.
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Figure 3. Change in prostate-specific antigen (PSA) as a function of baseline PSA at various time points of follow-up. The shaded area represents the 95% confidence interval (CI) for the best fit (solid) line.
Screenshot (25944).png
 
Figure 4. Longitudinal International Prostate Symptom Score (IPSS), IPSS quality of life (QOL), maximum urinary flow (Qmax), and post-void residual (PVR) outcomes comparing subgroup populations defined by baseline prostate size. CI indicates confidence interval.
Screenshot (25945).png

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