Aquablation therapy for symptomatic benign prostatic hyperplasia: a single-centre experience in 47 patients

BJU Int. 2018 Jun;121(6):945-951. doi: 10.1111/bju.14126. Epub 2018 Feb 4.


Objective: To report procedure process improvements and confirm the preserved safety and short-term effectiveness of a second-generation Aquablation device for the treatment of lower urinary tract symptoms (LUTS) attributable to benign prostatic hyperplasia (BPH) in 47 consecutive patients at a single institution.

Patients and methods: Aquablation was performed in 47 patients with symptomatic BPH at a single institution. Baseline, peri-operative and 3-month urinary function data were collected.

Results: The mean (range) patient age was 66 (50-79) years, and transrectal ultrasonography-measured prostate volume was 48 (20-118) mL. A median lobe was present in 25 patients (53%) and eight patients had catheter-dependent urinary retention. The mean (range) total procedure time was 35 (13-128) min and the tissue resection time was 4 (1-10) min. Five Clavien-Dindo grade I/II and five Clavien-Dindo grade III complications were recorded in eight patients. The mean (range) hospital stay was 3.1 (1-8) days and the mean (range) duration of urethral catheterization was 1.9 (1-11) days. The mean International Prostate Symptom Score (IPSS) decreased from 24.4 at baseline to 5 at 3 months; IPSS quality-of-life score decreased from 4.5 to 0.3 points; peak urinary flow rate increased from 7.1 to 16.5 mL/s and post-void residual urine volume decreased from 119 to 43 mL (all P < 0.01).

Conclusions: This study confirmed procedure process improvements resulting from system enhancements, with preservation of safety and effectiveness during use of a second-generation device for the treatment of LUTS attibutable to BPH in the largest single-institution study conducted to date.

Keywords: aquablation; benign prostatic hyperplasia; prospective study; robotics; surgical resection; waterjet.

Publication types

  • Clinical Trial

MeSH terms

  • Ablation Techniques / instrumentation
  • Ablation Techniques / methods*
  • Aged
  • Equipment Design
  • Humans
  • Length of Stay / statistics & numerical data
  • Lower Urinary Tract Symptoms / etiology
  • Lower Urinary Tract Symptoms / surgery*
  • Male
  • Middle Aged
  • Operative Time
  • Prospective Studies
  • Prostatic Hyperplasia / complications
  • Prostatic Hyperplasia / surgery*
  • Quality of Life
  • Treatment Outcome
  • Water


  • Water