1-year outcomes similar for waterjet and electrocautery-based prostate resection

  • Gilling P & al.
  • Urology
  • 12 Dec 2018

  • curated by Craig Hicks
  • Clinical Essentials
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Takeaway

  • 1-year safety and efficacy outcomes are similar for waterjet (Aquablation) and electrocautery-based prostate resection (TURP) for surgical treatment of benign prostatic hyperplasia (BPH).

Why this matters

  • Researchers previously reported 6-month results of a double-blinded prospective randomized controlled trial assessing a surgeon-planned, image-guided, robotically executed technique for resecting prostate tissue using a high-velocity waterjet; this study extends their findings to 1 year.

Study design

  • Researchers randomly assigned patients with BPH-related moderate to severe lower urinary tract symptoms to either TURP or Aquablation (N=181).
  • Primary endpoints:
    • Reduction in International Prostate Symptom Score and improvement in uroflow parameters (efficacy).
    • Occurrence of persistent Clavien-Dindo grade 1 or higher complications (safety).
  • Funding: PROCEPT BioRobotics.

Key results

  • Both groups showed similar BPH symptom score improvements, with 12-month reduction of 15.1 points, and had marked postoperative increases of mean maximum urinary flow rates (Aquablation, 10.3 cc/second; TURP, 10.6 cc/second; P=.8632).
  • Patient PSA levels were reduced in both groups by 1 point (P<.01>
  • Surgical retreatment rates within 1 year of initial treatment were 1.5% for TURP and 2.6% for Aquablation.
  • Patients experienced no procedure-related adverse events after 6 months.

Limitations

  • Prostate size was limited to 80 cc.
  • Follow-up was limited to 12 months.