Rodrigo Suarez-Ibarrola1, Thorsten Bach2, Simon Hein3, Andrea Cocci4, Giorgio Ivan Russo5, Thomas R W Herrmann6, Christian Gratzke3, Arkadiusz Miernik3. 1. Department of Urology, Faculty of Medicine, University of Freiburg-Medical Centre, Freiburg, Germany. rodrigo.suarez@uniklinik-freiburg.de. 2. Department of Urology, Asklepios Hospital Harburg, Hamburg, Germany. 3. Department of Urology, Faculty of Medicine, University of Freiburg-Medical Centre, Freiburg, Germany. 4. Department of Urology, University of Florence, Florence, Italy. 5. Department of Urology, University of Catania, Catania, Italy. 6. Department of Urology, Spital Thurgau AG, Frauenfeld, Switzerland.
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 (Qmax) 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.
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 (Qmax) 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.
Entities:
Keywords:
Aquabeam; Aquablation; Benign prostatic enlargement; Benign prostatic hyperplasia; Ejaculatory dysfunction; Transurethral resection of the prostate; Urinary clinical outcomes
Authors: Nicola Frego; Alberto Saita; Paolo Casale; Pietro Diana; Roberto Contieri; Pier Paolo Avolio; Massimo Lazzeri; Rodolfo Hurle; Nicolò Maria Buffi; Giorgio Ferruccio Guazzoni; Giovanni Lughezzani Journal: World J Urol Date: 2021-04-03 Impact factor: 4.226
Authors: Iman Sadri; Adel Arezki; Félix Couture; David-Dan Nguyen; Russell Schwartz; Ahmed S Zakaria; Dean Elterman; Enrique Rijo; Vincent Misrai; Thorsten Bach; Claus G Roehrborn; Kevin C Zorn Journal: World J Urol Date: 2020-08-01 Impact factor: 4.226