Aquablation for benign prostatic obstruction: Single center technique evolution and experience

Abstract

Purpose: Aquablation is a new technology that relies on real-time ultrasound guidance to ablate prostatic tissues using high ve-locity pressurized water. We hereby present our data and experience in this technique by exploring the perioperative surgical and functional outcomes. Materials and Methods: This is a prospectively filled study including consecutive patients who underwent aquablation at our Middle Eastern tertiary care center. Patient demographics, voiding parameters, and prostate disease specific variables were col-lected. We reported on the surgical and functional outcomes as well as the 3-month adverse events. We also explored the trend in hemoglobin drop and hemostasis method by dividing the consecutive cases into four temporal periods. Results: Fifty-nine patients underwent aquablation between March 2018 and March 2020. Mean time from transrectal ultrasound to Foley insertion was 48.5±2.5 minutes. Cautery was performed in 35 patients (59.3%) and a catheter-tensioning device was mounted in 50 patients (84.7%). On average, the hemoglobin dropped by-1.7±0.2 ng/dL (p<0.0001). The average length of cath-eterization and hospital stay were 2.1±0.3 days and 2.2±0.1 days, respectively. Only three patients (5.1%) were re-hospitalized. At three months, the average drop in serum prostate-specific antigen was-36.6±6.0% (p<0.0001) and functional outcomes consider-ably improved. We also recorded 14 adverse events in 13 patients (overall rate of 22.0%), with grade 1 and grade 2 complications comprising 71.4% of all adverse events. Conclusions: Our study results confirm the safety and efficacy of the aquablation procedure in the adoption phase. © The Korean Urological Association.