Iman Sadri1, Adel Arezki1, Félix Couture2, David-Dan Nguyen1, Russell Schwartz3, Ahmed S Zakaria3, Dean Elterman4, Enrique Rijo5, Vincent Misrai6, Thorsten Bach7, Claus G Roehrborn8, Kevin C Zorn9. 1. Faculty of Medicine, McGill University, Montreal, QC, Canada. 2. Division of Urology, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada. 3. Division of Urology, Centre Hospitalier de L'Université de Montréal, Montreal, QC, Canada. 4. Division of Urology, University Health Network, University of Toronto, Toronto, ON, Canada. 5. Department of Urology, Hospital Quirón Salud, Barcelona, Spain. 6. Department of Urology, Clinique Pasteur, Toulouse, France. 7. Department of Urology, Asklepios Westklinikum Rissen, Hamburg, Germany. 8. Department of Urology, University of Texas Southwestern Medical Centre, Dallas, TX, USA. 9. Division of Urology, Centre Hospitalier de L'Université de Montréal, Montreal, QC, Canada. zorn.chumurology@gmail.com.
Abstract
PURPOSE: In this review, we will discuss the state of the literature regarding Aquablation, its limitations, and opportunities for its application in the treatment of benign prostatic enlargement (BPE). METHODS: A comprehensive review of original research on Aquablation was conducted. Articles related to transurethral resection of the prostate, holmium laser enucleation of the prostate, greenlight photoselective vaporization of the prostate, and simple prostatectomy were reviewed for discussion. RESULTS: For small-medium prostates (30-80 mL), Aquablation's main advantages include better ejaculatory function and similar functional outcomes compared to TURP. For large prostates (80-150 mL), Aquablation demonstrates shorter operative time and superior ejaculatory function when compared to simple prostatectomy, HoLEP, and Greenlight PVP. In addition, Aquablation displays shorter hospital stays than simple prostatectomy. The integration of software programming and semi-automatic technology increases the reproducibility of the procedure and helps standardize overall outcomes, while also accelerating the learning curve. Its ability to preserve antegrade ejaculation makes Aquablation a very compelling option for sexually active patients. However cost and postoperative bleeding risks remain a concern. CONCLUSION: The current evidence suggests that Aquablation is a safe and effective alternative for BPE for small to large prostates. Further prospective clinical trials, with comparisons to other BPE modalities, and data from longer follow-up periods are still required.
PURPOSE: In this review, we will discuss the state of the literature regarding Aquablation, its limitations, and opportunities for its application in the treatment of benign prostatic enlargement (BPE). METHODS: A comprehensive review of original research on Aquablation was conducted. Articles related to transurethral resection of the prostate, holmium laser enucleation of the prostate, greenlight photoselective vaporization of the prostate, and simple prostatectomy were reviewed for discussion. RESULTS: For small-medium prostates (30-80 mL), Aquablation's main advantages include better ejaculatory function and similar functional outcomes compared to TURP. For large prostates (80-150 mL), Aquablation demonstrates shorter operative time and superior ejaculatory function when compared to simple prostatectomy, HoLEP, and Greenlight PVP. In addition, Aquablation displays shorter hospital stays than simple prostatectomy. The integration of software programming and semi-automatic technology increases the reproducibility of the procedure and helps standardize overall outcomes, while also accelerating the learning curve. Its ability to preserve antegrade ejaculation makes Aquablation a very compelling option for sexually active patients. However cost and postoperative bleeding risks remain a concern. CONCLUSION: The current evidence suggests that Aquablation is a safe and effective alternative for BPE for small to large prostates. Further prospective clinical trials, with comparisons to other BPE modalities, and data from longer follow-up periods are still required.
Authors: Mihir M Desai; Abhishek Singh; Shashank Abhishek; Abhishek Laddha; Harshad Pandya; Akbar N Ashrafi; Arvind P Ganpule; Claus G Roehrborn; Andrew J Thomas; Mahesh Desai; Ravindra B Sabnis Journal: BJU Int Date: 2018-02-04 Impact factor: 5.588
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Authors: Vincent Misrai; Enrique Rijo; Kevin C Zorn; Nicolas Barry-Delongchamps; Aurelien Descazeaud Journal: Eur Urol Date: 2019-07-05 Impact factor: 20.096
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Authors: Mihir Desai; Mo Bidair; Naeem Bhojani; Andrew Trainer; Andrew Arther; Eugene Kramolowsky; Leo Doumanian; Dean Elterman; Ronald P Kaufman; James Lingeman; Amy Krambeck; Gregg Eure; Gopal Badlani; Mark Plante; Edward Uchio; Greg Gin; Larry Goldenberg; Ryan Paterson; Alan So; Mitch Humphreys; Claus Roehrborn; Steven Kaplan; Jay Motola; Kevin C Zorn Journal: BJU Int Date: 2018-06-10 Impact factor: 5.588