Open Access

ARTICLE

Three-year outcomes after Aquablation therapy compared to TURP: results from a blinded randomized trial

Peter Gilling¹, Neil Barber², Mohamed Bidair³, Paul Anderson⁴, Mark Sutton⁵, Tev Aho⁶, Eugene Kramolowsky⁷, Andrew Thomas⁸, Barrett Cowan⁹, Ronald P. Kaufman, Jr.¹⁰, Andrew Trainer¹¹, Andrew Arther¹¹, Gopal Badlani¹², Mark Plante¹³, Mihir Desai¹⁴, Leo Doumanian¹⁴, Alexis E. Te¹⁵, Mark DeGuenther¹⁶, Claus Roehrborn¹⁷

1 Tauranga Urology Research, Tauranga, New Zealand
2 Frimley Park Hospital, Frimley Health Foundation Trust, Surrey, United Kingdom
3 San Diego Clinical Trials, San Diego, California, USA
4 Royal Melbourne Hospital, Melbourne, Australia
5 Houston Metro Urology, Houston, Texas, USA
6 Addenbrooke’s Hospital, Cambridge University Hospitals, Cambridge, United Kingdom
7 Virginia Urology, Richmond, Virginia, USA
8 Princess of Wales Hospital, Bridgend, Wales, United Kingdom
9 Urology Associates, P.C., Englewood, Colorado, USA
10 Albany Medical College, Albany, New York, USA
11 Adult Pediatric Urology & Urogynecology, P.C., Omaha, Nebraska, USA
12 Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
13 University of Vermont Medical Center, Burlington, Vermont, USA
14 University of Southern California, Institute of Urology, Los Angeles, California, USA
15 Weill Cornell Medical College, New York, New York, USA
16 Urology Centers of Alabama, Birmingham, Alabama, USA
17 UT Southwestern Medical Center, University of Texas Southwestern, Dallas, Texas, USA
Address correspondence to Dr. Peter J. Gilling, Urology Bay of Plenty, 850 Cameron Road, PO Box 56, Tauranga 3110 New Zealand

Canadian Journal of Urology 2020, 27(1), 10072-10079.

Abstract

Introduction: To compare 3-year efficacy and safety after prostate resection with Aquablation therapy or transurethral resection of the prostate (TURP) for the treatment of lower urinary tract symptoms related to benign prostate hyperplasia (BPH).
Materials and methods: One hundred and eighty-one patients assigned to either Aquablation therapy or TURP were followed for 3 years postoperatively. Patients and follow-up assessors were blinded to treatment. Assessments included International Prostate Symptom Score (IPSS), Male Sexual Health Questionnaire (MSHQ-EjD), International Index of Erectile Function (IIEF) and uroflow.
Results: Over 3 years of treatment, improvements in IPSS scores were statistically similar across groups. Mean 3-year improvements were 14.4 and 13.9 points in the Aquablation and TURP groups, respectively (difference of 0.6 points, 95% CI -3.3–2.2, p = .6848). Similarly, 3-year improvements in Qmax were 11.6 and 8.2 cc/sec (difference of 3.3 [95% CI -0.5-7.1] cc/sec, p = .0848). At 3 years, PSA was reduced significantly in both groups by 0.9 and 1.1 ng/mL, respectively; the reduction was similar across groups (p = .5983). There were no surgical retreatments for BPH beyond 20 months for either Aquablation or TURP.
Conclusions: Three-year BPH symptom reduction and urinary flow rate improvement were similar after TURP and Aquablation therapy. No subjects required surgical retreatment beyond 20 months postoperatively. (ClinicalTrials.gov number, NCT02505919).

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