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01-05-2020 | Benign Prostatic Hypertrophy | Invited Review

Efficacy and safety of aquablation of the prostate for patients with symptomatic benign prostatic enlargement: a systematic review

Authors: Rodrigo Suarez-Ibarrola, Thorsten Bach, Simon Hein, Andrea Cocci, Giorgio Ivan Russo, Thomas R. W. Herrmann, Christian Gratzke, Arkadiusz Miernik

Published in: World Journal of Urology | Issue 5/2020

Abstract

Purpose

The aim of this systematic review is to summarize the contemporary literature on aquablation and evaluate its safety and efficacy for the treatment of symptomatic BPE.

Evidence acquisition

A systematic search of English language literature was performed using the PubMed-MEDLINE and Web of Science libraries up to 24 July 2019 by combining PICO (patient population, intervention, comparison, and outcome) terms. We retrieved 16 studies, including 446 patients treated with aquablation eligible for data extraction and analysis. Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines were followed.

Evidence synthesis

We identified a randomized controlled trial (RCT) comparing aquablation to transurethral resection of the prostate (TURP) with 6-month, 1-year, and 2-year outcomes, three single-center and single-arm studies, three multicenter and single-arm studies, and five subgroup analyses. Aquablation significantly improved International Prostate Symptom Score (IPSS), IPSS-quality of life (IPSS-QoL), maximum urinary flow rate (Q_max) and post void residual (PVR) from baseline to last follow-up in all prospective studies. At 2-year follow-up, aquablation showed non-inferior symptom relief compared to TURP, with a lower risk of anejaculation favoring aquablation and no significant differences regarding Clavien–Dindo events. Although a significant hemoglobin drop was reported in all aquablation single-arm studies and when compared to TURP, it did not translate into increased transfusion rates.

Conclusions

Data from the WATER trial demonstrates that aquablation is comparable to TURP in effectively improving symptom scores and functional parameters related to BPE and bladder outlet obstruction. The evidence provided supports the safety of aquablation assessed by procedure-related adverse events.

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Title: Efficacy and safety of aquablation of the prostate for patients with symptomatic benign prostatic enlargement: a systematic review
Authors: Rodrigo Suarez-Ibarrola
Thorsten Bach
Simon Hein
Andrea Cocci
Giorgio Ivan Russo
Thomas R. W. Herrmann
Christian Gratzke
Arkadiusz Miernik
Publication date: 01-05-2020
Publisher: Springer Berlin Heidelberg
Keywords: Benign Prostatic Hypertrophy
Benign Prostatic Hypertrophy
Transurethral Prostate Resection
Published in: World Journal of Urology / Issue 5/2020
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-019-02959-5

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Springer Medicine

Efficacy and safety of aquablation of the prostate for patients with symptomatic benign prostatic enlargement: a systematic review

Abstract

Purpose

Evidence acquisition

Evidence synthesis

Conclusions

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Springer Medicine

Abstract

Purpose

Evidence acquisition

Evidence synthesis

Conclusions

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