Reasons to overthrow TURP: bring on Aquablation

Area of Science:

• Urology
• Minimally Invasive Surgery
• Prostate Health

Background:

• Benign prostatic enlargement (BPE) affects a significant number of aging men.
• Current surgical options for BPE have varying efficacy and side effect profiles.
• There is a need for innovative BPE treatments with improved outcomes and patient satisfaction.

Purpose of the Study:

• To review the current literature on Aquablation for BPE treatment.
• To evaluate the efficacy, limitations, and applications of Aquablation.
• To compare Aquablation with established BPE surgical modalities.

Main Methods:

• Comprehensive literature review of original research on Aquablation.
• Inclusion of studies on transurethral resection of the prostate (TURP), holmium laser enucleation of the prostate (HoLEP), GreenLight photoselective vaporization of the prostate (PVP), and simple prostatectomy for comparative analysis.

Main Results:

• Aquablation shows comparable functional outcomes to TURP for small-medium prostates (30-80 mL), with improved ejaculatory function.
• For large prostates (80-150 mL), Aquablation offers shorter operative times and superior ejaculatory function compared to simple prostatectomy, HoLEP, and GreenLight PVP.
• The technology enhances procedural reproducibility and reduces the learning curve. Preservation of antegrade ejaculation is a key advantage for sexually active patients, though cost and bleeding risks are considerations.

Conclusions:

• Aquablation is a safe and effective treatment option for BPE across a range of prostate sizes.
• Further prospective clinical trials are necessary to validate these findings.
• Longer follow-up data and direct comparisons with other BPE treatments are required to fully establish Aquablation's role.