Aquablation is safe and effective for treating lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) in men with large prostates, according to a new study.

The procedure, which involves the use of high-pressure waterjets to resect tissue, was associated with significant improvements in symptoms, peak flow rate (Qmax), and post-void residual volume.

Faysal A. Yafi, MD, of the University of California Irvine, and collaborators studied 82 men with prostate volumes of 80 to 150 cc who underwent Aquablation for moderate-to-severe BPH-related LUTS. Aquablation involves the use of high-pressure waterjets to resect tissue.

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Patients had a mean prostate volume of 108 cc before treatment. The mean operative time was 38.2 minutes and mean Aquablation resection time was 7.7 min. The average hospital length of stay after the procedure was 1.6 days. Mean International Prostate Symptom Scores were 23.7 and 7.1 before and 3 months after treatment, respectively, Dr Yafi’s team reported online ahead of print in the International Journal of Impotence Research. In addition, mean Qmax was 9.2 mL/sec before treatment and 19.5 mL/sec 3 months post-treatment. Mean post-void residual volumes were 120.6 cc before treatment compared with 50.6 cc 3 months post-treatment. The observed Clavien-Dindo grade 2 or higher event rate at 3 months was 34.1%.

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“In a 3-month U.S. cohort analysis, Aquablation appears to provide a strong surgical alternative in patients with LUTS/BPH due to larger prostate volumes with good functional outcomes, and relatively short operative time and length of hospital stay, and acceptable complication and transfusion rates.”


Yafi FA, Tallman CT, Seard ML, Jordan ML. Aquablation outcomes for the U.S. cohort of men with LUTS due to BPH in large prostates (80-150 cc). Int J Impot Res. 2018; published online ahead of print.