MP20-02: Four-Year Outcomes of Aquablation with Ultrasound Guidance: Largest Real-World, Single-Center Study and Longest Follow-Up Data for Innovative BPH Treatment

Aquablation is an innovative, ultrasound-guided, robot-assisted water jet technology used to ablate prostatic tissue for men with benign prostatic hyperplasia (BPH), aiming to preserve sexual function and reduce operative time. This study presents 4-year safety and efficacy outcomes from a real-world, single-center experience involving 265 men with moderate-to-severe BPH symptoms, treated between December 2019 and October 2023. The average prostate volume was 106.3 mL, with a range of 38-293 mL. Of the cohort, 41.9% were in urinary retention preoperatively, and 97.3% of these men were able to void without a catheter post-Aquablation. One year after the procedure, prostate volume had decreased by an average of 41.1 mL, and the mean International Prostate Symptom Score (IPSS) had improved significantly, dropping from 24.2 to 5.1 over the 4-year follow-up period. Urinary flow rates also improved, with peak urinary flow (Qmax) increasing from 6.4 mL/sec to 16.9 mL/sec. Notably, 99% of men maintained antegrade ejaculation postoperatively, highlighting Aquablation’s success in preserving sexual function. Complications were minimal, with 2.3% of men requiring a blood transfusion, 6.4% experiencing a postoperative urinary tract infection, and 0.4% having bladder neck disruption. Five men (1.8%) required surgical retreatment during the study period. Overall, this study demonstrates that Aquablation is a safe and effective treatment for BPH with durable results at 4 years, showing significant improvements in both symptoms and urinary flow while preserving sexual function. The outcomes are consistent with previous registration data, confirming its effectiveness in a real-world setting.