Skip to main content
Top
Published in: Advances in Therapy 6/2019

Open Access 01-06-2019 | Benign Prostatic Hypertrophy | Original Research

Two-Year Outcomes After Aquablation Compared to TURP: Efficacy and Ejaculatory Improvements Sustained

Authors: Peter Gilling, Neil Barber, Mohamed Bidair, Paul Anderson, Mark Sutton, Tev Aho, Eugene Kramolowsky, Andrew Thomas, Barrett Cowan, Ronald P. Kaufman Jr., Andrew Trainer, Andrew Arther, Gopal Badlani, Mark Plante, Mihir Desai, Leo Doumanian, Alexis E. Te, Mark DeGuenther, Claus Roehrborn

Published in: Advances in Therapy | Issue 6/2019

Login to get access

Abstract

Introduction

To compare 2-year safety and efficacy outcomes after Aquablation or transurethral resection of the prostate (TURP) for the treatment of lower urinary tract symptoms related to benign prostate hyperplasia (BPH).

Methods

One hundred eighty-one patients with BPH were assigned at random (2:1 ratio) to either Aquablation or TURP. Patients and follow-up assessors were blinded to treatment. Assessments included the International Prostate Symptom Score (IPSS), Male Sexual Health Questionnaire (MSHQ), International Index of Erectile Function and uroflow. The focus of analysis was 2-year outcomes.

Results

At 2 years, IPSS scores improved by 14.7 points in the Aquablation group and 14.9 points in TURP (p = .8304, 95% CI for difference − 2.1 to 2.6 points). Two-year improvements in maximum flow rate (Qmax) were large in both groups at 11.2 and 8.6 cc/s for Aquablation and TURP, respectively (p = 0.1880, 95% CI for difference − 1.3 to 6.4). Sexual function as assessed by MSHQ was stable in the Aquablation group and decreased slightly in the TURP group. At 2 years, PSA was reduced significantly in both groups by 0.7 and 1.2 points, respectively; the reduction was similar across groups (p = 0.1816). Surgical retreatment rates after 12 months for Aquablation were 1.7% and 0% for TURP. Over 2 years, surgical BPH retreatment rates were 4.3% and 1.5% (p = 0.4219), respectively.

Conclusion

Two-year efficacy outcomes after TURP and Aquablation were similar, and the rate of surgical retreatment was low and similar to TURP.

Trial Registration

ClinicalTrials.gov no. NCT02505919.

Funding

PROCEPT BioRobotics.
Appendix
Available only for authorised users
Literature
1.
go back to reference Trueman P, Hood SC, Nayak US, et al. Prevalence of lower urinary tract symptoms and self-reported diagnosed “benign prostatic hyperplasia”, and their effect on quality of life in a community-based survey of men in the UK. BJU Int. 1999;83:410–5.CrossRefPubMed Trueman P, Hood SC, Nayak US, et al. Prevalence of lower urinary tract symptoms and self-reported diagnosed “benign prostatic hyperplasia”, and their effect on quality of life in a community-based survey of men in the UK. BJU Int. 1999;83:410–5.CrossRefPubMed
2.
go back to reference Naslund MJ, Gilsenan AW, Midkiff KD, et al. Prevalence of lower urinary tract symptoms and prostate enlargement in the primary care setting. Int J Clin Pract. 2007;61:1437–45.CrossRefPubMed Naslund MJ, Gilsenan AW, Midkiff KD, et al. Prevalence of lower urinary tract symptoms and prostate enlargement in the primary care setting. Int J Clin Pract. 2007;61:1437–45.CrossRefPubMed
3.
go back to reference Madersbacher S, Marberger M. Is transurethral resection of the prostate still justified? BJU Int. 1999;83:227–37.CrossRefPubMed Madersbacher S, Marberger M. Is transurethral resection of the prostate still justified? BJU Int. 1999;83:227–37.CrossRefPubMed
4.
go back to reference McVary KT, Roehrborn CG, Avins AL, et al. Update on AUA guideline on the management of benign prostatic hyperplasia. J Urol. 2011;185:1793–803.CrossRefPubMed McVary KT, Roehrborn CG, Avins AL, et al. Update on AUA guideline on the management of benign prostatic hyperplasia. J Urol. 2011;185:1793–803.CrossRefPubMed
5.
go back to reference Miano R, De Nunzio C, Asimakopoulos AD, et al. Treatment options for benign prostatic hyperplasia in older men. Med Sci Monit Int Med J Exp Clin Res. 2008;14:RA94–R102. Miano R, De Nunzio C, Asimakopoulos AD, et al. Treatment options for benign prostatic hyperplasia in older men. Med Sci Monit Int Med J Exp Clin Res. 2008;14:RA94–R102.
6.
go back to reference Rassweiler J, Teber D, Kuntz R, et al. Complications of transurethral resection of the prostate (TURP)—incidence, management, and prevention. Eur Urol. 2006;50:969–79 (discussion 980).CrossRefPubMed Rassweiler J, Teber D, Kuntz R, et al. Complications of transurethral resection of the prostate (TURP)—incidence, management, and prevention. Eur Urol. 2006;50:969–79 (discussion 980).CrossRefPubMed
7.
go back to reference Montorsi F, Moncada I. Safety and tolerability of treatment for BPH. Eur Urol Suppl. 2006;5:1004–122.CrossRef Montorsi F, Moncada I. Safety and tolerability of treatment for BPH. Eur Urol Suppl. 2006;5:1004–122.CrossRef
8.
go back to reference Emberton M, Neal DE, Black N, et al. The effect of prostatectomy on symptom severity and quality of life. Br J Urol. 1996;77:233–47.CrossRefPubMed Emberton M, Neal DE, Black N, et al. The effect of prostatectomy on symptom severity and quality of life. Br J Urol. 1996;77:233–47.CrossRefPubMed
9.
go back to reference Gilling P, Barber N, Bidair M, et al. WATER: a double-blind, randomized, controlled trial of Aquablation® vs transurethral resection of the prostate in benign prostatic hyperplasia. J Urol. 2018;199:1252–61.CrossRefPubMed Gilling P, Barber N, Bidair M, et al. WATER: a double-blind, randomized, controlled trial of Aquablation® vs transurethral resection of the prostate in benign prostatic hyperplasia. J Urol. 2018;199:1252–61.CrossRefPubMed
10.
go back to reference Barry MJ, Fowler FJ, O’Leary MP, et al. The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. J Urol. 1992;148:1549–57 (discussion 1564).CrossRefPubMed Barry MJ, Fowler FJ, O’Leary MP, et al. The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. J Urol. 1992;148:1549–57 (discussion 1564).CrossRefPubMed
11.
go back to reference Gilling P, Reuther R, Kahokehr A, et al. Aquablation—image-guided robot-assisted waterjet ablation of the prostate: initial clinical experience. BJU Int. 2016;117:923–9.CrossRefPubMed Gilling P, Reuther R, Kahokehr A, et al. Aquablation—image-guided robot-assisted waterjet ablation of the prostate: initial clinical experience. BJU Int. 2016;117:923–9.CrossRefPubMed
12.
go back to reference Aljuri N, Gilling P, Roehrborn C. How I do it: balloon tamponade of prostatic fossa following Aquablation. Can J Urol. 2017;24:8937–40.PubMed Aljuri N, Gilling P, Roehrborn C. How I do it: balloon tamponade of prostatic fossa following Aquablation. Can J Urol. 2017;24:8937–40.PubMed
13.
go back to reference Dindo D, Demartines N, Clavien P-A. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.CrossRefPubMedPubMedCentral Dindo D, Demartines N, Clavien P-A. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.CrossRefPubMedPubMedCentral
14.
go back to reference Li S, Zeng X-T, Ruan X-L, et al. Holmium laser enucleation versus transurethral resection in patients with benign prostate hyperplasia: an updated systematic review with meta-analysis and trial sequential analysis. PLoS One. 2014;9:e101615.CrossRefPubMedPubMedCentral Li S, Zeng X-T, Ruan X-L, et al. Holmium laser enucleation versus transurethral resection in patients with benign prostate hyperplasia: an updated systematic review with meta-analysis and trial sequential analysis. PLoS One. 2014;9:e101615.CrossRefPubMedPubMedCentral
15.
go back to reference Bachmann A, Tubaro A, Barber N, et al. 180-W XPS GreenLight laser vaporisation versus transurethral resection of the prostate for the treatment of benign prostatic obstruction: 6-month safety and efficacy results of a European Multicentre Randomised Trial–the GOLIATH study. Eur Urol. 2014;65:931–42.CrossRefPubMed Bachmann A, Tubaro A, Barber N, et al. 180-W XPS GreenLight laser vaporisation versus transurethral resection of the prostate for the treatment of benign prostatic obstruction: 6-month safety and efficacy results of a European Multicentre Randomised Trial–the GOLIATH study. Eur Urol. 2014;65:931–42.CrossRefPubMed
16.
go back to reference McVary KT, Roehrborn CG. Three-year outcomes of the prospective, randomized controlled Rezūm system study: convective radiofrequency thermal for treatment of lower urinary tract symptoms due to benign prostatic hyperplasia. Urology. 2018;111:1–9.CrossRefPubMed McVary KT, Roehrborn CG. Three-year outcomes of the prospective, randomized controlled Rezūm system study: convective radiofrequency thermal for treatment of lower urinary tract symptoms due to benign prostatic hyperplasia. Urology. 2018;111:1–9.CrossRefPubMed
17.
go back to reference Roehrborn CG, Gange SN, Shore ND, et al. The prostatic urethral lift for the treatment of lower urinary tract symptoms associated with prostate enlargement due to benign prostatic hyperplasia: the L.I.F.T. study. J Urol. 2013;190:2161–7.CrossRefPubMed Roehrborn CG, Gange SN, Shore ND, et al. The prostatic urethral lift for the treatment of lower urinary tract symptoms associated with prostate enlargement due to benign prostatic hyperplasia: the L.I.F.T. study. J Urol. 2013;190:2161–7.CrossRefPubMed
18.
go back to reference Chughtai B, Thomas D. Pooled aquablation results for american men with lower urinary tract symptoms due to benign prostatic hyperplasia in large prostates (60–150 cc). Adv Ther. 2018;35:832–8.CrossRefPubMed Chughtai B, Thomas D. Pooled aquablation results for american men with lower urinary tract symptoms due to benign prostatic hyperplasia in large prostates (60–150 cc). Adv Ther. 2018;35:832–8.CrossRefPubMed
Metadata
Title
Two-Year Outcomes After Aquablation Compared to TURP: Efficacy and Ejaculatory Improvements Sustained
Authors
Peter Gilling
Neil Barber
Mohamed Bidair
Paul Anderson
Mark Sutton
Tev Aho
Eugene Kramolowsky
Andrew Thomas
Barrett Cowan
Ronald P. Kaufman Jr.
Andrew Trainer
Andrew Arther
Gopal Badlani
Mark Plante
Mihir Desai
Leo Doumanian
Alexis E. Te
Mark DeGuenther
Claus Roehrborn
Publication date
01-06-2019
Publisher
Springer Healthcare
Published in
Advances in Therapy / Issue 6/2019
Print ISSN: 0741-238X
Electronic ISSN: 1865-8652
DOI
https://doi.org/10.1007/s12325-019-00952-3

Other articles of this Issue 6/2019

Advances in Therapy 6/2019 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.