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Urology. 2019 Mar;125:169-173. doi: 10.1016/j.urology.2018.12.002. Epub 2018 Dec 12.

Randomized Controlled Trial of Aquablation versus Transurethral Resection of the Prostate in Benign Prostatic Hyperplasia: One-year Outcomes.

Author information

1
Tauranga Urology Research, Tauranga, New Zealand. Electronic address: peter@urobop.co.nz.
2
Frimley Park Hospital, Frimley Health Foundation Trust, Surrey, UK.
3
San Diego Clinical Trials, San Diego, CA.
4
Royal Melbourne Hospital, Melbourne, Australia.
5
Houston Metro Urology, Houston, TX.
6
Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK.
7
Virginia Urology, Richmond, VA.
8
Princess of Wales Hospital, Bridgend, Wales, UK.
9
Urology Associates, P.C., Englewood, CO.
10
UT Southwestern Medical Center, Department of Urology, University of Texas Southwestern, Dallas, TX.

Abstract

OBJECTIVE:

To report 1-year safety and efficacy outcomes after either Aquablation or transurethral resection of the prostate (TURP) for the treatment of lower urinary tract symptoms related to benign prostatic hyperplasia (BPH) METHODS: This double-blinded, multicenter prospective randomized controlled trial assigned 181 patients with BPH-related moderate-to-severe lower urinary tract symptoms to either electrocautery-based prostate resection (TURP) or Aquablation. Efficacy endpoints included reduction in International Prostate Symptom Score and improvement in uroflow parameters. The primary safety endpoint was the occurrence of Clavien-Dindo persistent grade 1 or grade 2 or higher complications.

RESULTS:

BPH symptom score improvements were similar across groups with 12-month reduction of 15.1 points after TURP or Aquablation. In both groups, mean maximum urinary flow rates increased markedly postoperatively, with mean improvements of 10.3 cc/s for Aquablation versus 10.6 cc/s for TURP (P = .8632). At 1 year, Prostate-specific antigen (PSA) was reduced significantly (P < .01) in both groups by 1 point; the reduction was similar across groups (P = .9125). Surgical retreatment for BPH rates for TURP were 1.5% and Aquablation 2.6% within 1 year from the study procedure (P = not significant (NS)). The rate of late complications was low, with no procedure-related adverse events after month 6.

CONCLUSION:

The 1-year outcomes after TURP and Aquablation were similar and the rate of late procedure-related complications was low. (ClinicalTrials.gov number, NCT02505919).

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