Two-Year Outcomes After Aquablation Compared to TURP: Efficacy and Ejaculatory Improvements Sustained

IntroductionTo compare 2-year safety and efficacy outcomes after Aquablation or transurethral resection of the prostate (TURP) for the treatment of lower urinary tract symptoms related to benign prostate hyperplasia (BPH).MethodsOne hundred eighty-one patients with BPH were assigned at random (2:1 ratio) to either Aquablation or TURP. Patients and follow-up assessors were blinded to treatment. Assessments included the International Prostate Symptom Score (IPSS), Male Sexual Health Questionnaire (MSHQ), International Index of Erectile Function and uroflow. The focus of analysis was 2-year outcomes.ResultsAt 2years, IPSS scores improved by 14.7 points in the Aquablation group and 14.9 points in TURP (p=.8304, 95% CI for difference -2.1 to 2.6 points). Two-year improvements in maximum flow rate (Q(max)) were large in both groups at 11.2 and 8.6cc/s for Aquablation and TURP, respectively (p=0.1880, 95% CI for difference -1.3 to 6.4). Sexual function as assessed by MSHQ was stable in the Aquablation group and decreased slightly in the TURP group. At 2 years, PSA was reduced significantly in both groups by 0.7 and 1.2 points, respectively; the reduction was similar across groups (p=0.1816). Surgical retreatment rates after 12months for Aquablation were 1.7% and 0% for TURP. Over 2 years, surgical BPH retreatment rates were 4.3% and 1.5% (p=0.4219), respectively.ConclusionTwo-year efficacy outcomes after TURP and Aquablation were similar, and the rate of surgical retreatment was low and similar to TURP.Trial RegistrationClinicalTrials.gov no. NCT02505919.FundingPROCEPT BioRobotics.