WATER vs WATER II 3-Year Update: Comparing Aquablation Therapy for Benign Prostatic Hyperplasia in 30-80 cc and 80-150 cc Prostates.

To compare the outcomes of Aquablation for small-to-moderate (30-80cc) prostates with the outcomes for large (80-150 cc) prostates at 3-yr follow up.

WATER is a prospective, double-blind, multicenter, international clinical trial comparing the safety and efficacy of Aquablation and TURP in the treatment of LUTS/BPH in men 45-80 yr with a prostate of 30cc-80cc.

WATER II is a prospective, multicenter, single-arm international clinical trial of Aquablation in men with a prostate of 80cc-150cc. We compare 36-mo outcomes amongst 116 WATER and 101 WATER II study subjects undergoing Aquablation.

International Prostate Symptom Score (IPSS) scores improved from 22.9 and 23.2 at baseline in WATER and WATER II, respectively, to 8.0 and 6.5 at 36-mo, with 36-mo reductions of 14.4 and 16.3 points, respectively (p=0.247). At baseline, urinary flow rate (Qmax) was 9.4 and 8.7 cc/sec in WATER and WATER II, improving to 20.6 and 18.5 cc/sec, respectively (p=0.552) at 36-mo. Improvements in both IPSS and Qmax were immediate and sustained throughout follow-up. At 3yr, 98% and 94% of treated patients were BPH medication-free in WATER and WATER II, respectively (p=0.038). At 3yr, 96% and 97% of treated patients were free from surgical retreatment in WATER and WATER II, respectively (p=0.613).

Three-year follow-up demonstrates that Aquablation therapy leads to sustained outcomes, few irreversible complications, and low retreatment rates for the treatment of LUTS/BPH independently of prostate volume.

Urology. 2022 Apr 22 [Epub ahead of print]

Anis Assad, David-Dan Nguyen, Neil Barber, Mo Bidair, Peter Gilling, Paul Anderson, Gopal Badlani, Mitch Humphreys, Steven Kaplan, Ronald Kaufman, Alan So, Ryan Paterson, Mihir Desai, Claus Roehrborn, Bilal Chughtai, Kevin C Zorn, Dean Elterman, Naeem Bhojani

Division of Urology, Centre Hospitalier de l'Université de Montréal, Montreal, Canada., Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada., Department of Urology, Frimley Park Hospital, Frimley, UK., San Diego Clinical Trials, San Diego, CA, USA., Department of Urology, Bay of Plenty District Health Board Clinical School, Tauranga, New Zealand., Department of Urology, Royal Melbourne Hospital, Melbourne, Australia., Department of Urology, Wake Forest School of Medicine, Winston-Salem, NC, USA., Department of Urology, Mayo Clinic, Phoenix, AZ, USA., Department of Urology, Mount Sinai Hospital, New York, NY, USA., Division of Urology, Albany Medical College, Albany, NY, USA., Urologic Sciences, University of British Columbia, Vancouver, Canada., USC Institute of Urology, University of Southern California, Los Angeles, CA, USA., Department of Urology, UT Southwestern Medical Centre, Dallas, TX, USA., Department of Urology, Weill Cornell Medical College of Cornell University, New York, New York, USA., Division of Urology, University of Toronto, Toronto, Canada., Division of Urology, Centre Hospitalier de l'Université de Montréal, Montreal, Canada. Electronic address: .

Go Beyond the Abstract and Read a Commentary by the Authors