Open Access

ARTICLE

Aquablation versus transurethral resection of the prostate: 1 year United States – cohort outcomes

Veeru Kasivisvanathan^1,2,3, Muddassar Hussain⁴

1 Division of Surgery and Interventional Sciences, University College London, United Kingdom
2 Deparment of Urology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
3 British Urology Researchers in Surgical Training (BURST) Research Collaborative, United Kingdom
4 Frimley Park Hospital, Frimley Health Foundation Trust, Surrey, United Kingdom
Address correspondence to Dr. Veeru Kasivisvanathan, Division of Surgery and Interventional Science, University College London, 3rd Floor, Charles Bell House, 43-45 Foley Street, London W1W 7TS UK

Canadian Journal of Urology 2018, 25(3), 9317-9322.

Abstract

Introduction: The purpose of this analysis was to compare Aquablation to transurethral resection of the prostate (TURP) with respect to efficacy and safety at 1 year for the treatment of lower urinary tract symptoms related to benign prostatic hyperplasia (BPH) in the United States (U.S.) cohort from the Waterjet Ablation Therapy for Endoscopic Resection of prostate tissue (WATER) study.
Materials and methods: WATER is a double-blinded, multicenter prospective randomized controlled trial for patients with moderate-to-severe lower urinary tract symptoms related to BPH. Men were randomized to TURP or Aquablation. The efficacy and safety outcomes at 1 year were evaluated for the U.S. cohort. The efficacy objective was reduction in International Prostate Symptom Score (IPSS). The safety objective was the occurrence of Clavien-Dindo persistent grade 1 or grade 2 or higher operative complications.
Results: Ninety patients were randomized and treated between December 2015 and December 2016. Change in IPSS at 1 year between Aquablation and TURP was similar (14.5 versus 13.8, respectively, p = 0.7117). The number of subjects experiencing persistent Clavien-Dindo grade 1 or Clavien-Dindo grade 2 or higher adverse events was lower in the Aquablation group compared to the TURP group (20% versus 47%, respectively, p = 0.0132). Amongst sexually active subjects, the rate of anejaculation was lower in patients treated with Aquablation than TURP (9% versus 45%, respectively, p = 0.0006).
Conclusions: Surgical prostate resection using Aquablation showed improvement in lower urinary tract symptoms at 1 year comparable to TURP, but with a lower risk of adverse events and ejaculatory dysfunction.

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