This study aims to compare the long-term outcomes of Aquablation for small-to-moderate (30-80 cm3) prostates with the outcomes for large (80-150 cm3) prostates at 5-year follow up.
The Waterjet Ablation Therapy for Endoscopic Resection of Prostate Tissue (WATER; NCT02505919) is a prospective, double-blind, international clinical trial encompassing 116 patients, examining Aquablation versus transurethral resection of the prostate (TURP) for LUTS/BPH in prostates sized between 30 and 80 cm3. In parallel, WATER II (W-II; NCT03123250), a prospective, multicentre, single-arm international clinical trial, explores Aquablation outcomes in prostates ranging from 80 to 150 cm3. Baseline parameters and 60-month outcomes were scrutinized using statistical analyses, including Students' t test, Wilcoxon tests for continuous variables, and Fisher's test for binary variables.
There is a significant improvement in International Prostate Symptom Score (IPSS) from baseline to 60 months in both WATER (22.9 to 7.0) and WATER II (23.2 to 6.8) (P = 0.852). Urinary flow rate (Qmax) increased in both groups from baseline to 60 months (WATER: 9.4 to 17.3 cc/s; WATER II: 8.7 to 17.1 cc/s) (P = 0.933). Immediate and sustained enhancements were observed in IPSS and Qmax. At 5 years, a notable percentage of patients in both groups were BPH medication-free (WATER: 99%; WATER II: 94%) (P = 0.0517) and free from surgical retreatment (WATER: 95%; WATER II: 97%) (P = 0.508).
The 5-year follow-up affirms that Aquablation therapy exhibits sustained outcomes, minimal irreversible complications, and low retreatment rates for treating LUTS/BPH, irrespective of prostate volume ranging from 30 to 150 cm3.
BJUI compass. 2024 Sep 09*** epublish ***
Mohamad Baker Berjaoui, David-Dan Nguyen, Saud Almousa, Karim Daher, Neil Barber, Mo Bidair, Peter Gilling, Paul Anderson, Kevin C Zorn, Gopal Badlani, Mitch Humphreys, Steven Kaplan, Ronald P Kaufman, Dean Elterman, Mihir Desai, Claus Roehrborn, Naeem Bhojani
Division of Urology University of Toronto Toronto Canada., Department of Urology Centre Hospitalier de l'Universite de Montreal Montreal Canada., Clemenceau Medical Center Beirut Lebanon., Department of Urology Frimley Park Hospital Frimley UK., San Diego Clinical Trials San Diego California 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 North Carolina USA., Department of Urology Mayo Clinic Phoenix Arizona USA., Department of Urology Mount Sinai Hospital New York New York USA., Department of Urology Albany Medical College Albany New York USA., Department of Urology University of Southern California Los Angeles California USA., Department of Urology UT Southwestern Medical Centre Dallas Texas USA.