From the Guidelines
Hydroablation is a viable treatment option for Benign Prostatic Hyperplasia (BPH) patients with prostate volume <80g, offering sustained improvements in urinary symptoms and quality of life, as evidenced by a 50% improvement in IPSS scores and 49% improvement in IPSS-QoL at 3 years 1. The procedure, also known as Aquablation, utilizes a robotic handpiece and console to deliver a high-velocity water jet that precisely removes prostate tissue, resulting in significant improvements in IPSS, IPSS-QoL, and Qmax scores. Key benefits of hydroablation include:
- Sustained improvements in urinary symptoms and quality of life for at least 3 years
- Reduced risk of sexual dysfunction and preservation of ejaculatory function in most cases
- Shorter recovery time compared to traditional surgical approaches
- Ability to treat moderate to severe BPH symptoms in patients who have not responded to medications The mechanism behind hydroablation's effectiveness lies in its ability to precisely remove obstructing prostate tissue while minimizing damage to surrounding structures, resulting in significant improvements in urinary symptoms and quality of life, as demonstrated by the 3-year results showing a mean change from baseline in IPSS of -11.0 points and a mean score of 10.4 points, representing a 50% improvement from baseline 1.
From the Research
Hydroablation for BPH
- Hydroablation, also known as Aquablation, is a minimally invasive surgical procedure used to treat Benign Prostatic Hyperplasia (BPH) 2.
- The procedure involves the use of a high-velocity water jet to ablate the obstructing prostatic tissue, which is guided by real-time transrectal ultrasound imaging 2.
- Studies have shown that Aquablation is safe and effective in treating symptomatic BPH, with significant improvements in urinary flow rates and symptom scores 2, 3.
Efficacy and Safety
- A large multicentre international prospective randomised blinded clinical trial (WATER) demonstrated non-inferior symptom relief compared to transurethral prostate resection (TURP), with a lower risk of sexual dysfunction 2.
- Another study found that Aquablation is feasible and safe in treating men with large prostates (80-150 mL) 2.
- The complication rate for Aquablation is relatively low, with a high-grade complication rate of less than 1.4% 4.
Outcomes and Results
- A meta-analysis of individual patient data from four prospective clinical studies found significant improvements in functional outcomes following Aquablation, regardless of prostate volume or anatomy 5.
- Patients with moderate to severe lower urinary tract symptoms (LUTS) and overactive bladder showed a reduction in incontinence symptoms post-procedure 5.
- The surgical retreatment rate due to BPH symptoms was low, at 0.7% (95% CI 0.1%-2.0%) 5.
Comparison to Other Treatments
- Aquablation has been compared to TURP, with similar efficacy and a lower risk of sexual dysfunction 2.
- Finasteride, a medication used to treat BPH, has been shown to be effective in improving urinary flow rates and symptom scores, but may have a slower onset of action and more side effects compared to Aquablation 6.