Functional and surgical outcomes of Aquablation in elderly men.
Aquablation
BPH
Elderly
Robotics
Journal
World journal of urology
ISSN: 1433-8726
Titre abrégé: World J Urol
Pays: Germany
ID NLM: 8307716
Informations de publication
Date de publication:
Oct 2022
Oct 2022
Historique:
received:
23
05
2022
accepted:
11
08
2022
pubmed:
31
8
2022
medline:
28
9
2022
entrez:
30
8
2022
Statut:
ppublish
Résumé
As benign prostatic hyperplasia (BPH) is an age-related process, growing interest in surgical management for elderly men has emerged. Recently, Aquablation was approved for treatment of BPH associated lower urinary tract symptoms (LUTS) and utilizes robotic ultrasound guided surgeon-controlled waterjet ablation. We assessed the differences in functional and surgical outcomes between elderly and young men undergoing Aquablation for BPH/LUTS. We retrospectively assessed prospectively collected data from the WATER I (NCT02505919) and WATER II (NCT03123250) clinical trials reporting safety and efficacy of Aquablation in the treatment of LUTS/BPH in men 45-80 years with a prostate between 30 and 80 cc, and 80 cc and 150 cc, respectively. Men ≥ 65 years were defined as elderly and men < 65 years as young. Of 217 patients included, 83 (38.2%) were young and 134 (61.8%) were elderly. Mean age (SD) was 59.3 (± 3.4) years and 71.2 (± 4.2) years for young and elderly men, respectively. At 3 years of follow-up compared to baseline, elderly men showed similar reductions in total IPSS (7.68 points vs 7.12 points, p > 0.05) and similar increases in Qmax (20.6 mL/s vs 19.3 mL/s, p > 0.05) compared to young men. The ejaculatory dysfunction rate was similar for both cohorts (12.0% vs 9.7%, p > 0.05). Elderly men experienced similar annual retreatment rates compared to young men (1.5% vs 0.8% p > 0.05). Elderly men undergoing Aquablation have similar functional and surgical outcomes as young men. Elderly patient BPH surgical counseling should, therefore, consider Aquablation as a treatment option for LUTS/BPH.
Identifiants
pubmed: 36040501
doi: 10.1007/s00345-022-04137-6
pii: 10.1007/s00345-022-04137-6
doi:
Substances chimiques
Water
059QF0KO0R
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2515-2520Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Bushman W (2009) Etiology, epidemiology, and natural history of benign prostatic hyperplasia. Urol Clin North Am 36(4):403–415
doi: 10.1016/j.ucl.2009.07.003
Bortnick E, Brown C, Simma-Chiang V, Kaplan SA (2020) Modern best practice in the management of benign prostatic hyperplasia in the elderly. Ther Adv Urol 12:1756287220929486
doi: 10.1177/1756287220929486
Piao S, Choo MS, Kim M, Jeon HJ, Oh SJ (2016) Holmium laser enucleation of the prostate is safe for patients above 80 years: a prospective study. Int Neurourol J 20(2):143–150
doi: 10.5213/inj.1630478.239
Elshal AM, Elmansy HM, Elhilali MM (2013) Transurethral laser surgery for benign prostate hyperplasia in octogenarians: safety and outcomes. Urology 81(3):634–639
doi: 10.1016/j.urology.2012.11.042
Holman CD, Wisniewski ZS, Semmens JB, Rouse IL, Bass AJ (1999) Mortality and prostate cancer risk in 19,598 men after surgery for benign prostatic hyperplasia. BJU Int 84(1):37–42
doi: 10.1046/j.1464-410x.1999.00123.x
Gilling P, Reuther R, Kahokehr A, Fraundorfer M (2016) Aquablation–image-guided robot-assisted waterjet ablation of the prostate: initial clinical experience. BJU Int 117(6):923–929
doi: 10.1111/bju.13358
Sadri I, Arezki A, Couture F, Nguyen DD, Schwartz R, Zakaria AS et al (2021) Reasons to overthrow TURP: bring on Aquablation. World J Urol 39(7):2291–2299
doi: 10.1007/s00345-020-03390-x
Bach PDMT, Barber N, Elterman D et al (2022) Aquablation outcomes in men with LUTS due to BPH following single versus multi-pass treatments. Urology S0090–4295(22):00599–00604. https://doi.org/10.1016/j.urology.2022.07.007
doi: 10.1016/j.urology.2022.07.007
Elmansy H, Baazeem A, Kotb A, Badawy H, Riad E, Emran A et al (2012) Holmium laser enucleation versus photoselective vaporization for prostatic adenoma greater than 60 ml: preliminary results of a prospective, randomized clinical trial. J Urol 188(1):216–221. https://doi.org/10.1016/j.juro.2012.02.2576
doi: 10.1016/j.juro.2012.02.2576
pubmed: 22591968
Gao B, Lu S, Bhojani N, Zorn KC, Chughtai B, Elterman D (2021) Office-Based procedures for BPH. Curr Urol Rep 22(12):63. https://doi.org/10.1007/s11934-021-01081-7
doi: 10.1007/s11934-021-01081-7
pubmed: 34913101
Chughtai B, Thomas D (2018) Pooled Aquablation results for American men with lower urinary tract symptoms due to benign prostatic hyperplasia in large prostates (60–150 cc). Adv Ther 35(6):832–838
doi: 10.1007/s12325-018-0722-0
Kim JK, Cho MC, Son H, Ku JH, Oh SJ, Paick JS (2017) Patient perception of ejaculatory volume reduction after Holmium Laser Enucleation of the Prostate (HoLEP). Urology 99:142–147
doi: 10.1016/j.urology.2016.09.037
Ghobrial FK, Shoma A, Elshal AM, Laymon M, El-Tabey N, Nabeeh A et al (2020) A randomized trial comparing bipolar transurethral vaporization of the prostate with GreenLight laser (xps-180watt) photoselective vaporization of the prostate for treatment of small to moderate benign prostatic obstruction: outcomes after 2 years. BJU Int 125(1):144–152
doi: 10.1111/bju.14926
Gilling P, Barber N, Bidair M, Anderson P, Sutton M, Aho T et al (2020) Three-year outcomes after Aquablation therapy compared to TURP: results from a blinded randomized trial. Can J Urol 27(1):10072–10079
pubmed: 32065861
Nguyen DD, Misraï V, Bach T, Bhojani N, Lingeman JE, Elterman DS et al (2020) Operative time comparison of Aquablation, greenlight PVP, ThuLEP, GreenLEP, and HoLEP. World J Urol 38(12):3227–3233
doi: 10.1007/s00345-020-03137-8
Bozzini G, Berti L, Aydoğan TB, Maltagliati M, Roche JB, Bove P et al (2021) A prospective multicenter randomized comparison between Holmium Laser Enucleation of the Prostate (HoLEP) and Thulium Laser Enucleation of the Prostate (ThuLEP). World J Urol 39(7):2375–2382
doi: 10.1007/s00345-020-03468-6
Garden EB, Ravivarapu KT, Levy M, Chin CP, Omidele O, Tomer N et al (2022) The utilization and safety of same-day discharge after transurethral benign prostatic hyperplasia surgery: a case-control, matched analysis of a national cohort. Urology S0090–4295(22):00095–00104
Mmeje CO, Nunez-Nateras R, Warner JN, Humphreys MR (2013) Age-stratified outcomes of holmium laser enucleation of the prostate. BJU Int 112(7):982–989. https://doi.org/10.1111/bju.12063
doi: 10.1111/bju.12063
pubmed: 23510326
Gu X, Strom K, Spaliviero M, Wong C (2012) Does age affect the efficacy and safety of GreenLight HPS
doi: 10.3109/13685538.2011.632452
pubmed: 22129103
Stout TE, Fazio A, Walczak EG, Ordonez M (2021) Evaluating the perceived importance of male ejaculatory function. Urology 147:162–166
doi: 10.1016/j.urology.2020.09.020
Bouhadana D, Nguyen DD, Zorn KC, Elterman DS, Bhojani N (2020) Patient perspectives on benign prostatic hyperplasia surgery: a focus on sexual health. J Sex Med 17(10):2108–2112
doi: 10.1016/j.jsxm.2020.07.006