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Adv Ther. 2019 Jun;36(6):1326-1336. doi: 10.1007/s12325-019-00952-3. Epub 2019 Apr 26.

Two-Year Outcomes After Aquablation Compared to TURP: Efficacy and Ejaculatory Improvements Sustained.

Author information

1
Tauranga Urology Research, Tauranga, New Zealand. peter@urobop.co.nz.
2
Frimley Park Hospital, Frimley Health Foundation Trust, Surrey, UK.
3
San Diego Clinical Trials, San Diego, CA, USA.
4
Royal Melbourne Hospital, Melbourne, Australia.
5
Houston Metro Urology, Houston, TX, USA.
6
Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK.
7
Virginia Urology, Richmond, VA, USA.
8
Princess of Wales Hospital, Bridgend, Wales, UK.
9
Urology Associates, P.C., Englewood, CO, USA.
10
Albany Medical College, Albany, NY, USA.
11
Adult Pediatric Urology & Urogynecology, P.C., Omaha, NE, USA.
12
Wake Forest School of Medicine, Winston-Salem, NC, USA.
13
University of Vermont Medical Center, Burlington, VT, USA.
14
Institute of Urology, University of Southern California, Los Angeles, CA, USA.
15
Weill Cornell Medical College, New York, NY, USA.
16
Urology Centers of Alabama, Birmingham, AL, USA.
17
Department of Urology, UT Southwestern Medical Center, University of Texas Southwestern, Dallas, TX, USA.

Abstract

INTRODUCTION:

To compare 2-year safety and efficacy outcomes after Aquablation or transurethral resection of the prostate (TURP) for the treatment of lower urinary tract symptoms related to benign prostate hyperplasia (BPH).

METHODS:

One hundred eighty-one patients with BPH were assigned at random (2:1 ratio) to either Aquablation or TURP. Patients and follow-up assessors were blinded to treatment. Assessments included the International Prostate Symptom Score (IPSS), Male Sexual Health Questionnaire (MSHQ), International Index of Erectile Function and uroflow. The focus of analysis was 2-year outcomes.

RESULTS:

At 2 years, IPSS scores improved by 14.7 points in the Aquablation group and 14.9 points in TURP (p = .8304, 95% CI for difference - 2.1 to 2.6 points). Two-year improvements in maximum flow rate (Qmax) were large in both groups at 11.2 and 8.6 cc/s for Aquablation and TURP, respectively (p = 0.1880, 95% CI for difference - 1.3 to 6.4). Sexual function as assessed by MSHQ was stable in the Aquablation group and decreased slightly in the TURP group. At 2 years, PSA was reduced significantly in both groups by 0.7 and 1.2 points, respectively; the reduction was similar across groups (p = 0.1816). Surgical retreatment rates after 12 months for Aquablation were 1.7% and 0% for TURP. Over 2 years, surgical BPH retreatment rates were 4.3% and 1.5% (p = 0.4219), respectively.

CONCLUSION:

Two-year efficacy outcomes after TURP and Aquablation were similar, and the rate of surgical retreatment was low and similar to TURP.

TRIAL REGISTRATION:

ClinicalTrials.gov no. NCT02505919.

FUNDING:

PROCEPT BioRobotics.

KEYWORDS:

Aquablation; BPH; Robotic surgery; TURP; Urology

PMID:
31028614
DOI:
10.1007/s12325-019-00952-3

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