WATER II (80–150 mL) procedural outcomes

Desai, Mihir; Bidair, Mohamed; Bhojani, Naeem; Trainer, Andrew; Arther, Andrew; Kramolowsky, Eugene V.; Doumanian, Leo; Elterman, Dean; Kaufman, Ronald P.; Lingeman, James E.; Krambeck, Amy E.; Eure, Gregg; Badlani, Gopal H.; Plante, Mark; Uchio, Edward; Gin, Greg; Goldenberg, Larry; Paterson, Ryan F.; So, Alan; Humphreys, Mitch; Roehrborn, C.; Kaplan, Steven A.; Motola, Jay; Zorn, Kevin C.

doi:10.1111/bju.14360

Cited by 68 publications

(29 citation statements)

References 19 publications

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“…In WATER, a blinded randomized trial of aquablation vs TURP in prostates with volumes of 30–80 mL, aquablation was shown to have efficacy similar to that of TURP but with a much lower risk of sexual side effects . After previously reporting procedural outcomes , in the present paper we report 6‐month efficacy data from WATER II, a prospective multicentre trial of aquablation in men with symptomatic BPH and prostate volumes 80–150 mL.…”

Section: Introductionmentioning

confidence: 91%

Aquablation for benign prostatic hyperplasia in large prostates (80–150 mL): 6‐month results from the WATER II trial

et al. 2019

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Objective To present 6‐month safety and effectiveness data from a multicentre prospective study of aquablation in men with lower urinary tract symptoms (LUTS) attributable to benign prostatic hyperplasia (BPH) with prostate volumes between 80 and 150 mL. Methods Between September and December 2017, 101 men with LUTSattributable to BPHwere prospectively enrolled at 16 centres in Canada and the USA. Results The mean prostate volume was 107 mL. The mean length of hospital stay after the aquablation procedure was 1.6 days (range: same day to 6 days). The primary safety endpoint (Clavien–Dindo grade 2 or higher or any grade 1 event resulting in persistent disability) at 3 months occurred in 45.5% of men, which met the study design goal of < 65% (P < 0.001). At 6 months, 22% of the patients had experienced a Clavien–Dindo grade 2, 14% a grade 3 and 5% a grade 4 adverse event. Bleeding complications requiring intervention and/or transfusion were recorded in eight patients prior to discharge and in six patients after discharge. The mean International Prostate Symptom Score improved from 23.2 ± 6.3 at baseline to 6.7 ± 5.1 at 3 months, meeting the study's primary efficacy endpoint goal (P < 0.001). The maximum urinary flow rate increased from 8.7 to 18.8 mL/s (P < 0.001) and post‐void residual urine volume decreased from 131 at baseline to 47 at 6 months (P < 0.0001). At 6 months, prostate‐specific antigen concentration reduced from 7.1 ± 5.9 ng/mL at baseline to 4.0 ± 3.9 ng/mL, a 44% reduction. Conclusions Aquablation is safe and effective in treating men with larger prostates (80–150 mL), without significant increase in procedure or resection time.

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Section: Introductionmentioning

confidence: 91%

Aquablation for benign prostatic hyperplasia in large prostates (80–150 mL): 6‐month results from the WATER II trial

et al. 2019

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“…The majority of research focusing on the use of Aquablation for large prostates is derived from the Water II study, 2,3 which was a multicenter international prospective trial that reported procedural outcomes in men with an average prostate volume of 107 cc. 2 Eighty-three percent of these patients had an intravesical median lobe with an average protrusion distance of 1.8 cm into the bladder. The study highlighted the ability of Aquablation to treat larger prostate volumes at short operating room times (mean, range; 55 minutes, 51-58 minutes) and short resection times (mean, range; 8 minutes, 3-17 minutes).…”

Section: Discussionmentioning

confidence: 98%

“…Contemporary literature shows a shift toward endoluminal minimally invasive techniques for bladder outlet obstruction, such as holmium laser enucleation of the prostate (HoLEP) 1 and more recently Aquablation. 2,3 Aquablation utilizes realtime ultrasonography with a robotically guided waterjet to ablate prostate tissue. Data regarding the efficacy and safety of Aquablation for large prostates, including prostates with intravesical median lobes, are limited to a single prospec-tive, multi-institutional, and international trial.…”

Section: Introductionmentioning

confidence: 99%

Aquablation for the Treatment of Benign Prostatic Hyperplasia in a Large Volume Prostate with an Intravesical Median Lobe

Ghiraldi

Ambinder

Son

et al. 2020

Journal of Endourology Case Reports

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Background: Aquablation is a relatively new minimally invasive technology for the treatment of benign prostatic hyperplasia (BPH) that has shown significant promise in its clinical efficacy and utility. Larger prostates or prostates with a median lobe are a common limitation to other minimally invasive treatment options. There is evidence that Aquablation maintains efficacy for larger prostates and prostates with an intravesical median lobe. Herein, we describe 3-month follow-up results for a patient who underwent Aquablation for a large prostate with a significant intravesical median lobe. Case: Our patient is a 72-year-old man with lower urinary tract symptoms secondary to BPH refractory to pharmacotherapy. Patient underwent Aquablation of the prostate, which was 110 cc in volume and had a large intravesical median lobe component. At 3-month follow-up patient had reduction in his AUA-SS from 21 to 12, improvement in uroflow from 8.2 to 16 mL/second, and improvement in postvoid residual from 90 to 13 mL. Conclusion: Aquablation has been shown to be efficacious for the treatment of BPH in patients with large prostates and intravesical median lobes. This case report further demonstrates effective treatment for patients who fit this profile.

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“…It is not yet clear whether aquablation would not be recommended for prostates below a certain size. In the more recent WATER II study in 101 men with a mean prostate volume of 107 mL, aquablation was also shown to be feasible and safe in men with large prostates (80–150 mL) .…”

mentioning

confidence: 98%

“…There will always be a possible downside to novel treatments and this may relate to poor radiological data entry which may, in turn, lead to sphincter damage, although this has not been an issue in the carefully controlled studies to date. There are also reports of troublesome postoperative bleeding in some cases, although haemostasis can be effectively achieved via a catheter balloon tamponade and traction device or by electrocautery .…”

mentioning

confidence: 99%

A novel robotic procedure for bladder outlet obstruction

Speakman

2019

BJU International

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WATER II (80–150 mL) procedural outcomes

Abstract: Aquablation is feasible and safe in treating men with men with large prostates (80-150 mL). The 6-month efficacy data are being accrued and will be presented in future publications (ClinicalTrials.gov number, NCT03123250).

Cited by 68 publications

References 19 publications

Aquablation for benign prostatic hyperplasia in large prostates (80–150 mL): 6‐month results from the WATER II trial

Aquablation for benign prostatic hyperplasia in large prostates (80–150 mL): 6‐month results from the WATER II trial

Aquablation for the Treatment of Benign Prostatic Hyperplasia in a Large Volume Prostate with an Intravesical Median Lobe

A novel robotic procedure for bladder outlet obstruction

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