Aquablation Outcomes for the U.S. Cohort of Men with LUTS Due to BPH in Large Prostates (80-150 cc)

Prostate surgery for lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) is one of the most common surgeries a man may encounter after the age of 50. The transurethral approach (TURP) has been performed for the last 100 years with the introduction of new cutting instruments over the last 20 years. While the objective is clear, remove the obstructive tissue, the process is highly varied based upon surgeon skill resulting in varied outcomes. Robotics comes to mind as the answer.

Current robotic surgery units available on the market are just extensions of the physician’s eyes and hands, and depend on surgeon expertise and skill level, thus leading to significant variability in outcomes. However, if the goal is to democratize surgery, it means improving surgical outcomes through the use of advanced robotics and informatics that would eliminate any variability due to individual surgeon skills.

Could urology surgeons be the first to step into this new era of robotic surgery with the AquaBeam system to treat men with LUTS due to BPH? This technique went first head to head in a randomized study against arguably the top 5% skilled TURP surgeons in the world and successfully met the endpoints in prostates 30-80cc. In the article presented here, the AquaBeam treated larger 80-150cc prostates, where transurethral options are limited, and showed nearly identical results as what was seen in the randomized study with smaller prostates.

As such, for the first time in 100 years, AquaBeam may have democratized prostate surgery, regardless of prostate size, with its real-time intra-operative imaging for surgeon planning and robotic execution thus removing the hand skill variability from the process.

Written by: Faysal A. Yafi, MD., FRCSC, Department of Urology, University of California Irvine, Irvine, CA, USA

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