Assistant Professor
Division of Urology
University Health Network, University of Toronto
Pooled analysis of bladder function post-aquablation
Dean S. Elterman1, Peter Gilling2, Claus Roehrborn3, Neil Barber4, Vincent Misrai5, Kevin C. Zorn6, Naeem Bhojani6, Alexis Te7, Mitch Humphreys8, Steven Kaplan9, Mihir Desai10, Thorsten Bach11.
1University Health Network, Toronto, ON, Canada; 2Tauranga Urology Research, Tauranga, New Zealand; 3University of Texas Southwestern, Dallas, TX, United States; 4Frimley Park Hospital, Frimley Health Foundation Trust, Surrey, United Kingdom; 5Clinique Pasteur, Toulouse, France; 6University of Montreal Hospital Center, Universite de Montreal, Montreal, QC, Canada; 7Weill Cornell Medical College, New York Presbyterian, New York, NY, United States; 8Mayo Clinic Arizona, Arizona, AZ, United States; 9Mount Sinai Medical Center, New York, NY, United States; 10University of Southern California, Los Angeles, CA, United States; 11Asklepios Westklinikum Hamburg, Hamburg, Germany
Introduction: Aquablation Therapy (AQUABEAM Robotic System, PROCEPT BioRobotics, Inc., USA) is an ultrasound-guided, robotically executed waterjet ablative procedure used to treat men with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). It has demonstrated treatment in a wide range of prostate sizes while minimizing irreversible complications (erectile dysfunction, ejaculatory dysfunction, incontinence). This analysis explores the bladder function following Aquablation in various prostate volume and anatomical subgroups.
Methods: Four prospective, global, clinical studies have been conducted with Aquablation with a minimum follow up of one year; WATER, WATER II, FRANCAIS WATER, and OPEN WATER. The focus of the analysis is the seven individual questions from IPSS and post-operative incontinence symptom index (ISI).
Results: 425 men with prostates ranging in size from 20-150cc were treated with Aquablation Therapy. Outcomes from the seven questions from the IPSS questionnaire are in Figure 1 for prostates <100c, prostates >100cc, prostate anatomy with median lobe, and prostate anatomy without median lobe. Regardless of subgroup, all outcomes are consistent and a significant improvement from baseline. Specifically, improvements in frequency, urgency, and nocturia demonstrate bladder function improvement. Patients entering treatment with severe incontinence, ISI score >4, and regardless of prostate size, showed a reduction in incontinence during patient follow-up.
Conclusions: Aquablation Therapy showed remarkable bladder function improvement following the index procedure. Additionally, men with severe incontinence showed a reduction in incontinence post-procedure.