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Related Experiment Video

Updated: May 26, 2025

Photoselective Vaporesection of the Prostate via an End-firing Lithium Triborate Crystal Laser
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Aquablation Compared with Simple Prostatectomy for Prostate Volumes >80 Grams.

David Gangwish1, Minhaj Jabeer1, Aidan Kennedy1

  • 1Corewell Health William Beaumont University Hospital, Royal Oak, Michigan, USA.

Journal of Endourology
|February 21, 2025
PubMed
Summary

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Editorial Comment.

The Journal of urology·2026

Aquablation (Aqua) offers benefits over simple prostatectomy (SP) in reduced transfusions, hospital stays, and operative times for benign prostatic hyperplasia. However, SP shows better long-term urinary symptom scores and lower retreatment rates.

Area of Science:

  • Urology
  • Surgical Technology
  • Medical Device Evaluation

Background:

  • Benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) significantly impact quality of life.
  • Traditional surgical interventions like simple prostatectomy (SP) have established efficacy but also associated morbidities.
  • Aquablation (Aqua) is an emerging minimally invasive technique for BPH treatment.

Purpose of the Study:

  • To compare the functional urinary outcomes, adverse events, and retreatment rates of Aquablation (Aqua) versus simple prostatectomy (SP).
  • To evaluate the safety and efficacy profiles of these two distinct surgical approaches for BPH management in large prostates (>80 mL).

Main Methods:

  • A retrospective chart review of 172 patients undergoing SP or Aqua for BPH from 2017-2023.
Keywords:
AquaAquablationlarge prostatesminimally invasivesimple prostatectomy

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  • Inverse probability of treatment weighting (IPTW) was used to adjust for baseline characteristic differences, including prostate size.
  • Key outcomes analyzed included International Prostate Symptom Score (IPSS), quality of life (QOL), blood transfusions, adverse events (AE), retreatment rates, and postoperative medication use.
  • Main Results:

    • Aquablation demonstrated significantly lower rates of blood transfusions, shorter hospital stays, and reduced operative times compared to SP.
    • Simple prostatectomy resulted in superior 1-year International Prostate Symptom Scores (IPSS) and lower retreatment rates.
    • Postoperative alpha-blocker use was less frequent after SP, while adverse events were comparable between the two groups.

    Conclusions:

    • Aquablation offers advantages in perioperative safety and efficiency, including fewer transfusions and shorter procedures.
    • Simple prostatectomy provides better long-term symptom control and lower reintervention needs for benign prostatic hyperplasia.
    • The choice between Aqua and SP may depend on balancing immediate surgical outcomes with long-term functional results and retreatment considerations.