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

Introduction To 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). Methods One 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. Results At 2 years, 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 8.6 cc/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 12 months 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. Conclusion Two-year efficacy outcomes after TURP and Aquablation were similar, and the rate of surgical retreatment was low and similar to TURP. Trial Registration ClinicalTrials.gov no. NCT02505919. Funding PROCEPT BioRobotics.