Outcomes for Aquablation Compared to Simple Prostatectomy From a Single Institution

Document Type

Conference Proceeding

Publication Date

5-2024

Publication Title

Journal of Urology

Abstract

INTRODUCTION AND OBJECTIVE: Aquablation (Aqua) for benign prostatic hyperplasia has been compared to transurethral resection of the prostate in multiple clinical trials. Aqua treatments have no limit to prostate size and can be considered in large prostates when traditionally a simple prostatectomy would be considered. The objective is to compare Aqua vs simple prostatectomy (SP) for urinary outcomes, adverse events (AE), and retreatment rates. METHODS: Single institution retrospective chart review for all men having undergone open/robotic SP or Aqua between January 2017 to October of 2022. Variables collected included blood transfusions, AE using Clavien-Dindo (CD), retreatment rates, post operative medication discontinuation, and American Urologic Association symptom scores (AUASS) with Quality-of-Life indicator (QOL). Statistical analysis was performed using independent sample T-Test and Chi-square(SPSS 28.0). RESULTS: 247 patients were enrolled with 174 Aquablation and 73 SP. Groups were matched for BMI (Aqua 28.23 vs SP 28.42,p[0.78) but Aquablation patients were older (72.3 vs 69.1, p[0.003),had smaller prostate volume (113.2 vs 184.4 cc, p[<0.001), and lower incidence of preoperative retention (20% vs 47%, p[<0.001). Aquablation resulted in lower incidence of blood transfusion (2.3% vs 20.8%,p[<0.001) and lower post operative hemoglobin drop (1.78 vs 2.91,p[<0.001), as well as shorter length of stay (1.75 vs 4.3 days, p[<0.001) and OR times (58.9 vs 173.9 minutes, p[<0.001). Patients who underwent Aquablation reported worse AUASS scores at one year (7.46 vs 3.22, p[<0.001) with worse QOL (1.47 vs 0.64, p[0.034). In addition, Aquablation patients were more likely to continue alpha blockers at 6 months (22.94% vs 4.41%, p[<0.001). Although not statistically significant, Aquablation had higher rates of surgical retreatment during follow up (12.9% vs 5.8%, p[0.108) but lower rates of adverse events (19% vs 30.1%, p[0.054) compared to SP. Average CD grades for those that had an AE were similar between Aquablation and SP (1.76 vs 1.95, p[0.441) with both Aqua and SP having 4AE CD≥3. CONCLUSIONS: Aquablation therapy was superior to simple prostatectomy with respect to OR time, length of stay, and blood transfusion postop but did not perform as well for subjective urinary outcomes at 1 year within our cohort.

Volume

211

Issue

5S

First Page

e321

Last Page

e322

Comments

American Urological Association Annual Meeting, May 3-6, 2024, San Antonio, TX

DOI

10.1097/01.JU.0001008732.80104.31.06

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