Aquablation for benign prostatic hyperplasia in large prostates (80-150 cc): 2-year results

Can J Urol. 2020 Apr;27(2):10147-10153.


Introduction: To report 2-year safety and effectiveness of the Aquablation procedure for the treatment of men with symptomatic benign prostatic hyperplasia (BPH) and large-volume 80-150 cc prostates.

Materials and methods: Between September-December 2017, 101 men with moderate-to-severe BPH symptoms and prostate volumes of 80-150 cc underwent an ultrasound-guided robotically executed Aquablation procedure in a prospective multicenter international clinical trial (WATER II). Baseline, procedural and follow up parameters were recorded at baseline and scheduled postoperative visits. Herein we report 2-year safety and efficacy for this cohort.

Results: Mean prostate volume was 107 cc (range 80-150 cc). Mean IPSS improved from 23.2 at baseline to 5.8 at 2 years (17-point improvement, p < .0001). Mean IPSS quality of life improved from 4.6 at baseline to 1.1 at 2 years (p < .0001). Maximum urinary flow increased from 8.7 to 18.2 cc/sec. Two subjects underwent a repeat procedure for BPH symptoms over the 2-year follow up period. By 2 years or study exit, all but 2 of 74 subjects stopped taking alpha blockers. Similarly, all but 4 of 32 subjects stopped taking 5α-reductase inhibitors.

Conclusions: Two-year prospective multicenter follow up demonstrated that the Aquablation procedure is safe and effective in the treatment of men with LUTS due to BPH and prostates 80-150 cc with durable treatment efficacy, acceptable safety profile and a low retreatment rate. number, NCT03123250.

Publication types

  • Multicenter Study

MeSH terms

  • Ablation Techniques / adverse effects
  • Ablation Techniques / methods*
  • Aged
  • Humans
  • Male
  • Middle Aged
  • Organ Size
  • Prospective Studies
  • Prostate / pathology*
  • Prostatectomy / methods*
  • Prostatic Hyperplasia / pathology*
  • Prostatic Hyperplasia / surgery*
  • Time Factors
  • Treatment Outcome
  • Water


  • Water

Associated data