Aquablation therapy is associated with 3-year outcomes similar to those of transurethral resection of the prostate (TURP) for the treatment of lower urinary tract symptoms related to benign prostatic hyperplasia (BPH), according to a new study.

At 3 years, men who underwent Aquablation—a minimally invasive procedure in which a high-velocity waterjet is used to resect prostate tissue—and TURP showed similar improvements in International Prostate Symptom Score (IPSS), maximal urinary flow rate (Qmax), and post-void residual (PVR).

Investigators compared the treatment approaches in a prospective study of 181 men, of whom 116 and 65 were randomly assigned to undergo Aquablation and TURP, respectively. Three-year follow-up data were available for 97 Aquablation and 55 TURP patients.

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The study included men aged 45 to 80 years with a prostate size of 30 to 80 mL (as measured by transrectal ultrasonography), moderate to severe lower urinary tract symptoms (LUTS) as indicated by an IPSS of 12 or higher, and a Qmax less than 15 mL/sec.

The mean reduction in IPSS at 3 years was 14.4 in the Aquablation group and 13.9 in the TURP arm, Peter Gilling, MD, of Tauranga Urology Research in Tauranga, New Zealand, and colleagues reported in the Canadian Journal of Urology. The mean percent reduction in IPSS score was 64% and 61%, respectively. The 3-year improvements in Qmax were 11.6 and 8.2 mL/sec, respectively. The mean 3-year reduction in PVR was 52 and 53 mL, respectively. The differences between the treatment arms were not statistically significant.

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No surgical retreatment was required for any patient beyond 20 months postoperatively, according to the investigators.

“Combined with results of other prospective trials, 3-year results from the current study provide compelling long term evidence for the safety and effectiveness of Aquablation therapy in men with LUTS due to BPH,” the authors wrote.

PROCEPT BioRobotics, which developed the Aquablation technology, funded the study.


Gilling P, Barber N, Bidair M, et al. Three-year outcomes after Aquablation therapy compared to TURP: results from a blinded randomize trial. Can J Urol. 2020;27:10072-10079.