Does Aquablation Therapy Improve Lower Urinary Tract Symptoms in Patients Aged ≥ 75 Years With Benign Prostatic...

Aquablation therapy is an effective treatment for benign prostatic obstruction. However, its functional outcomes in older patients remain underexplored. In this study, we aimed to compare improvements in lower urinary tract symptoms (LUTS) after Aquablation therapy in patients aged ≥ 75 and ≤ 74 years.

We retrospectively analyzed data from 103 men with moderate-to-severe LUTS who underwent Aquablation between 2023 and 2025. Patients were stratified into two age groups (years): ≤ 74 (n = 72) and ≥ 75 (n = 31). Primary outcomes included changes in the International Prostate Symptom Score (IPSS), IPSS-Quality of Life (IPSS-QoL), maximum urinary flow rate (Qmax), and post-void residual (PVR) from baseline to 3 months postoperatively. Secondary outcomes included transfusion and complication rates.

After 3 months, both groups showed significant improvements in total IPSS (-10.46 and -7.38 in those aged ≤ 74 and ≥ 75 years, respectively), QoL (-2.32 vs. -2.33), Qmax (+8.67 vs. +6.03 mL/s), and PVR (-89.1 vs. -75.3 mL; all p < 0.05). In the ≥ 75 group, voiding subscores, including incomplete emptying, intermittency, weak stream, and straining, improved significantly (p < 0.05), whereas storage symptoms, including frequency, urgency, and nocturia, did not (p = 0.07, 0.6, and 0.7, respectively). In patients aged ≤ 74 years, both voiding and storage symptom subscores improved significantly. No significant differences in operative time, transfusion rate, or complication rate were observed between groups.

Aquablation therapy is a safe and effective surgical option for patients aged ≥ 75 years. In this older population, although storage symptoms were less treatment-responsive, substantial improvements in voiding symptoms and overall QoL were achieved.