Aquablation for BPH/LUTS gives similar outcomes in young and elderly men: Study

Benign prostatic hyperplasia is an age-related process that causes prostate gland enlargement, leading to difficulty in urination. It has a negative impact on the quality of life and also contributes significantly to the economic burden. Due to this pathology, about 25% of men over 50 who develop LUTS will require surgical intervention.

An emergence of growing interest in surgical management for older men has emerged. Aquablation is a minimally invasive surgical technique approved recently for treating BPH-associated LUTS. It uses high-pressure saline for removing parenchymal tissue through a heat-free mechanism of hydrodissection. Robotic ultrasound-guided surgeon-controlled waterjet ablation is utilized in the technique.

Against the above background, Brendan L. Raizenne, Division of Urology, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada, and colleagues aimed to assess the differences in surgical and functional outcomes between young and elderly men undergoing Aquablation for BPH/LUTS.

For this purpose, the researchers assessed prospectively collected data from the clinical trials, WATER I and WATER II. These trials reported the safety and efficacy of Aquablation in LUTS/BPH treatment among men aged 45–80 years with a prostate between 30 and 80 cc, and 80 cc and 150 cc, respectively. Men above 65 years of age were defined as elderly, and those below 65 years as young.

The study included 217 patients, of whom 38.2% were young and 61.8% were elderly. The mean age respectively was 59.3 years and 71.2 years for young and elderly men.

The main findings of the study include:

• Compared to baseline, elderly men showed similar reductions in total IPSS (7.68 points vs. 7.12 points) at 3 years of follow-up and similar increases in Qmax (20.6 mL/s vs. 19.3 mL/s) compared to young men.
• For both cohorts, the ejaculatory dysfunction rate was similar (12.0% vs. 9.7%).
• Elderly men experienced similar annual retreatment rates compared to young men (1.5% vs 0.8%).

Elderly men undergoing Aquablation have similar functional and surgical outcomes as young men. Elderly patient BPH surgical counseling should consider Aquablation as a treatment option for LUTS/BPH.

Reference:

Raizenne, B.L., Bouhadana, D., Zorn, K.C. et al. Functional and surgical outcomes of Aquablation in elderly men. World J Urol (2022). https://doi.org/10.1007/s00345-022-04137-6