Open Access

ARTICLE

Aquablation for benign prostatic hyperplasia in large prostates (80-150 cc): 2-year results

Mihir Desai¹, Mo Bidair², Naeem Bhojani³, Andrew Trainer⁴, Andrew Arther⁴, Eugene Kramolowsky⁵, Leo Doumanian¹, Dean Elterman⁶, Ronald P. Kaufman, Jr.⁷, James Lingeman⁸, Amy Krambeck⁸, Gregg Eure⁹, Gopal Badlani¹⁰, Mark Plante¹¹, Edward Uchio¹², Greg Gin¹², Larry Goldenberg¹³, Ryan Paterson¹³, Alan So¹³, Mitchell R. Humphreys¹⁴, Claus G. Roehrborn¹⁵, Steven Kaplan¹⁶, Jay Motola¹⁶, Kevin C. Zorn³

1 University of Southern California, Institute of Urology, Los Angeles, California, USA
2 San Diego Clinical Trials, San Diego, California, USA
3 University of Montreal Hospital Center, Université de Montreal, Montreal, Quebec, Canada
4 Adult Pediatric Urology & Urogynecology, P.C., Omaha, Nebraska, USA
5 Virginia Urology, Richmond, Virginia, USA
6 University of Toronto - University Health Network, Toronto, Ontario, Canada
7 Albany Medical College, Albany, New York, USA
8 Indiana University Health Physicians, Indianapolis, Indiana, USA
9 Urology of Virginia, Virginia Beach, Virginia, USA
10 Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
11 University of Vermont Medical Center, Burlington, Vermont, USA
12 VA Long Beach Healthcare System, Long Beach, California, USA
13 University of British Columbia, Vancouver, British Columbia, Canada
14 Mayo Clinic Arizona, Scottsdale, Arizona, USA
15 UT Southwestern Medical Center, University of Texas Southwestern, Dallas, Texas, USA
16 Icahn School of Medicine at Mount Sinai, New York, New York, USA
Address correspondence to Dr. Mihir Desai, University of Southern California, Institute of Urology, 1441 Eastlake Ave, Suite 7416, Los Angeles, CA 90089 USA

Canadian Journal of Urology 2020, 27(2), 10147-10153.

Abstract

Introduction: To report 2-year safety and effectiveness of the Aquablation procedure for the treatment of men with symptomatic benign prostatic hyperplasia (BPH) and large-volume 80-150 cc prostates.
Materials and methods: Between September-December 2017, 101 men with moderate-to-severe BPH symptoms and prostate volumes of 80-150 cc underwent an ultrasound-guided robotically executed Aquablation procedure in a prospective multicenter international clinical trial (WATER II). Baseline, procedural and follow-up parameters were recorded at baseline and scheduled postoperative visits. Herein we report 2-year safety and efficacy for this cohort.
Results: Mean prostate volume was 107 cc (range 80-150 cc). Mean IPSS improved from 23.2 at baseline to 5.8 at 2 years (17-point improvement, p < .0001). Mean IPSS quality of life improved from 4.6 at baseline to 1.1 at 2 years (p < .0001). Maximum urinary flow increased from 8.7 to 18.2 cc/sec. Two subjects underwent a repeat procedure for BPH symptoms over the 2-year follow-up period. By 2 years or study exit, all but 2 of 74 subjects stopped taking alpha blockers. Similarly, all but 4 of 32 subjects stopped taking 5α-reductase inhibitors.
Conclusions: Two-year prospective multicenter follow-up demonstrated that the Aquablation procedure is safe and effective in the treatment of men with LUTS due to BPH and prostates 80-150 cc with durable treatment efficacy, acceptable safety profile, and a low retreatment rate. ClinicalTrials.gov number, NCT03123250.

---

Keywords

---