San Francisco—Men with large prostates experience more relief from BPH with treatment by Aquablation therapy (using the AquaBeam System) than with transurethral resection of the prostate (TURP), researchers say.
“Safety favors Aquablation,” Claus G. Roehrborn, MD, professor and chair of urology at the University of Texas Southwestern Medical School in Dallas, told Urology Times. He presented the findings at the AUA annual meeting in San Francisco.
Aquablation, which resects the prostate via robotic, high-velocity waterjet, can remove prostate tissue without applying heat. The procedure includes intraoperative transurethral ultrasound imaging and cystoscopic visualization. The surgeon creates a treatment plan prior to the therapy, then a robot executes the tissue removal while the patient is under general anesthesia.
A phase III randomized, clinical trial established that Aquablation can treat BPH more effectively than TURP, but researchers wanted to know whether it would work as well in men with particularly large prostates, defined as 50 mL to 80 mL. They analyzed subgroups pre-identified based on prostate volume. Eighty-two men had prostates less than 50 mL and 102 had prostates at least 50 mL.
Among the men with large prostates, the mean baseline International Prostate Symptom Score (IPSS) was 22.2 for those randomly assigned to TURP and 22.9 for those randomly assigned to Aquablation (p=.43). The two groups were similar in age, body mass index, lobes, degree of middle lobe obstruction, and mean prostate volume: 52 mL for TURP versus 54 mL for Aquablation (p=.31).