UP-88 Three-Year Outcomes after Aquablation Compared to TURP: Longest Reported Followup with SustainedEfficacy and Ejaculatory Improvements
Thursday June 27, 2019 from
Award Winner
Kevin C. C. Zorn, Canada has been granted the

Kevin C. C. Zorn, Canada

Associate Professor, Director of Robotic Surgery - CHUM, Minimally Invasive Uro-Oncologist

Section of Urology

University of Montreal Hospital Center (CHUM)


Three-year outcomes after Aquablation compared to TURP: Longest reported followup with sustained efficacy and ejaculatory improvements

Kevin C. Zorn1, Peter Gilling2, Neil Barber3, Mohamed Bidair3, Paul Anderson4, Mark Sutton5, Tev Aho3, Eugene Kramolowsky6, Dean S. Elterman1, Andy Thomas3, Barrett Cowan7, Ronald P Kaufman Jr7, Andrew Trainer7, Gopal Badlani7, Mark Plante7, Mihir Desai7, Leo Doumanian7, Alex E Te8, Mark DeGuenther9, Claus Roehrborn9.

1Urology, CHUM - University of Montreal Hospital Center, Montreal, QC, Canada; 2Urology, Urology Bay of Plenty, Tauranga, New Zealand; 3Urology, Frimley Health NHS, Surrey, United Kingdom; 4Urology, Royal Melbourne Hospital, Melbourne, Australia; 5Urology, Houston Methodist Hospital, Houston, TX, United States; 6Urology, Virginia Urology, Richmond, VA, United States; 7Urology, Keck Hospital of USC, Los Angeles, CA, United States; 8Urology, Weill Cornell Medicine, New York, NY, United States; 9Urology, UT Southwestern, Dallas, TX, United States

Introduction: To compare three-year (last follow-up of the protocol) safety and efficacy outcomes after Aquablation or transurethral resection of the prostate (TURP) for the treatment of lower urinary tract symptoms (LUTS) related to benign prostate hyperplasia (BPH).

Methods: 181 patients with BPH were assigned at random (2:1 ratio) to either Aquablation or TURP. Patients and follow-up assessors at each site were blinded to treatment. Assessments included International Prostate Symptom Score (IPSS), Male Sexual Health Questionnaire (MSHQ), International Index of Erectile Function (IIEF) and uroflow.

Results: At three years, IPSS scores improved by 14.2 points in the Aquablation group and 15 points in TURP (p=.7050, 95% CI for difference –3.6 to 5.3 points). Three-year improvements in maximum flow rate (Qmax) were large in both groups at 10 and 9.7 cc/sec for Aquablation (dark lines/black sqares) and TURP (grey dashed lines/triangles), respectively (p=.9078, 95% CI for difference –2.9 to 6.4). Sexual function as assessed by MSHQ-EjD was stable in the Aquablation group and decreased slightly in the TURP group; these changes persisted at year 3. At three years, PSA was reduced significantly in both groups but showed no difference between groups (p=.4074 for difference). The average annual retreatment occurrence was less than 2% in both treatment groups.

Conclusion: Three-year efficacy outcomes after TURP and Aquablation were similar and the rate of surgical retreatment was low and similar to TURP. Efficacy results have maintained their improvement since the 90 day follow-up for both groups that are consistent with all other resective surgical techniques.

Trial Registration: ClinicalTrials.gov number: NCT02505919.

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