nach oben

Erschienen in:

26.09.2019 | Invited Review

Efficacy and safety of aquablation of the prostate for patients with symptomatic benign prostatic enlargement: a systematic review

verfasst von: Rodrigo Suarez-Ibarrola, Thorsten Bach, Simon Hein, Andrea Cocci, Giorgio Ivan Russo, Thomas R. W. Herrmann, Christian Gratzke, Arkadiusz Miernik

Erschienen in: World Journal of Urology | Ausgabe 5/2020

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The aim of this systematic review is to summarize the contemporary literature on aquablation and evaluate its safety and efficacy for the treatment of symptomatic BPE.

Evidence acquisition

A systematic search of English language literature was performed using the PubMed-MEDLINE and Web of Science libraries up to 24 July 2019 by combining PICO (patient population, intervention, comparison, and outcome) terms. We retrieved 16 studies, including 446 patients treated with aquablation eligible for data extraction and analysis. Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines were followed.

Evidence synthesis

We identified a randomized controlled trial (RCT) comparing aquablation to transurethral resection of the prostate (TURP) with 6-month, 1-year, and 2-year outcomes, three single-center and single-arm studies, three multicenter and single-arm studies, and five subgroup analyses. Aquablation significantly improved International Prostate Symptom Score (IPSS), IPSS-quality of life (IPSS-QoL), maximum urinary flow rate (Q_max) and post void residual (PVR) from baseline to last follow-up in all prospective studies. At 2-year follow-up, aquablation showed non-inferior symptom relief compared to TURP, with a lower risk of anejaculation favoring aquablation and no significant differences regarding Clavien–Dindo events. Although a significant hemoglobin drop was reported in all aquablation single-arm studies and when compared to TURP, it did not translate into increased transfusion rates.

Conclusions

Data from the WATER trial demonstrates that aquablation is comparable to TURP in effectively improving symptom scores and functional parameters related to BPE and bladder outlet obstruction. The evidence provided supports the safety of aquablation assessed by procedure-related adverse events.

Faber K et al (2015) Image-guided robot-assisted prostate ablation using water jet-hydrodissection: initial study of a novel technology for benign prostatic hyperplasia. J Endourol 29(1):63–69PubMedCrossRef

Gravas S, Cornu JN, Drake MJ et al (2018) EAU guidelines on management of non-neurogenic male lower urinary tract symptoms (LUTS), incl. Benign Prostatic Obstruction (BPO). European Association of Urology

Gilling P et al (2016) Aquablation—image-guided robot-assisted waterjet ablation of the prostate: initial clinical experience. BJU Int 117(6):923–929PubMedCrossRef

Gilling P, Anderson P, Tan A (2017) Aquablation of the prostate for symptomatic benign prostatic hyperplasia: 1-year results. J Urol 197(6):1565–1572PubMedCrossRef

Pimentel MA, Nair SM, Gilling PJ (2016) Aquablation™: early clinical results. Curr Bladder Dysfunct Rep 11(2):130–133CrossRef

Taktak S et al (2018) Aquablation: a novel and minimally invasive surgery for benign prostate enlargement. Ther Adv Urol 10(6):183–188PubMedPubMedCentralCrossRef

Gilling P et al (2018) WATER: a double-blind, randomized, controlled trial of aquablation((R)) vs transurethral resection of the prostate in benign prostatic hyperplasia. J Urol 199(5):1252–1261PubMedCrossRef

Liberati A et al (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med 6(7):e1000100PubMedPubMedCentralCrossRef

Sterne JA et al (2016) ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ 355:i4919PubMedPubMedCentralCrossRef

10.

Misrai V et al (2019) Waterjet ablation therapy for treating benign prostatic obstruction in patients with small- to medium-size glands: 12-month results of the first french aquablation clinical registry. Eur Urol 19:297

11.

Bach T et al (2018) Aquablation of the prostate: single-center results of a non-selected, consecutive patient cohort. World J Urol 37(7):1369–1375PubMedCrossRef

12.

Desai MM et al (2018) Aquablation therapy for symptomatic benign prostatic hyperplasia: a single-centre experience in 47 patients. BJU Int 121(6):945–951PubMedCrossRef

13.

Desai M et al (2019) Aquablation for benign prostatic hyperplasia in large prostates (80–150 mL): 6-month results from the WATER II trial. BJU Int 124(2):321–328PubMedCrossRef

14.

Desai M et al (2019) WATER II (80–150 mL) procedural outcomes. BJU Int 123:106–112PubMedCrossRef

15.

Bhojani N et al (2019) Aquablation for benign prostatic hyperplasia in large prostates (80–150 cc): 1-year results. Urology 129:1–7PubMedCrossRef

16.

Gilling P et al (2019) Two-year outcomes after aquablation compared to TURP: efficacy and ejaculatory improvements sustained. Adv Ther 36(6):1326–1336PubMedPubMedCentralCrossRef

17.

Gilling P et al (2019) Randomized controlled trial of aquablation vs. transurethral resection of the prostate in benign prostatic hyperplasia: one-year outcomes. Urology 125:169–173PubMedCrossRef

18.

Kasivisvanathan V, Hussein M (2018) Aquablation versus transurethral resection of the prostate-1 year United States—cohort outcomes. Can J Urol 25(3):9317–9322PubMed

19.

Zorn KC et al (2018) Aquablation among novice users in Canada: a WATER II subpopulation analysis. Can Urol Assoc J 13(5):E113–E118PubMedPubMedCentralCrossRef

20.

Bhojani N et al (2018) Comparison of < 100 cc prostates and > 100 cc prostates undergoing aquablation for benign prostatic hyperplasia. World J Urol 37(7):1361–1368PubMedCrossRef

21.

Yafi FA et al (2018) Aquablation outcomes for the US cohort of men with LUTS due to BPH in large prostates (80–150 cc). Int J Impot Res 30(5):209–214PubMedCrossRef

22.

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):832–838PubMedCrossRef

23.

Aljuri N, Gilling P, Roehrborn C (2017) How I do it balloon tamponade. Can J Urol 24(4):8937–8940PubMed

24.

Yassaie O, Silverman JA, Gilling PJ (2017) Aquablation of the prostate for symptomatic benign prostatic hyperplasia: early results. Curr Urol Rep 18(12):91PubMedCrossRef

25.

Plante M et al (2018) Symptom relief and anejaculation after aquablation or transurethral resection of the prostate: subgroup analysis from a blinded randomized trial. BJU Int 123(4):651–660PubMedCrossRef

26.

Madersbacher S (2018) Re: WATER: a double-blind, randomized, controlled trial of aquablation vs transurethral resection of the prostate in benign prostatic hyperplasia. Eur Urol 74(2):233PubMedCrossRef

27.

Ploussard G, Tollon C (2016) Re: aquablation—image guided robotically-assisted waterjet ablation of the prostate: initial clinical experience. Eur Urol 69(6):1157–1158PubMedCrossRef

Titel: Efficacy and safety of aquablation of the prostate for patients with symptomatic benign prostatic enlargement: a systematic review
verfasst von: Rodrigo Suarez-Ibarrola
Thorsten Bach
Simon Hein
Andrea Cocci
Giorgio Ivan Russo
Thomas R. W. Herrmann
Christian Gratzke
Arkadiusz Miernik
Publikationsdatum: 26.09.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 5/2020
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-019-02959-5

Neu im Fachgebiet Urologie

Adjuvante Immuntherapie verlängert Leben bei RCC

25.04.2024 Nierenkarzinom Nachrichten

Nun gibt es auch Resultate zum Gesamtüberleben: Eine adjuvante Pembrolizumab-Therapie konnte in einer Phase-3-Studie das Leben von Menschen mit Nierenzellkarzinom deutlich verlängern. Die Sterberate war im Vergleich zu Placebo um 38% geringer.

Bei Senioren mit Prostatakarzinom auf Anämie achten!

24.04.2024 DGIM 2024 Nachrichten

Patienten, die zur Behandlung ihres Prostatakarzinoms eine Androgendeprivationstherapie erhalten, entwickeln nicht selten eine Anämie. Wer ältere Patienten internistisch mitbetreut, sollte auf diese Nebenwirkung achten.

Stufenschema weist Prostatakarzinom zuverlässig nach

22.04.2024 Prostatakarzinom Nachrichten

Erst PSA-Test, dann Kallikrein-Score, schließlich MRT und Biopsie – ein vierstufiges Screening-Schema kann die Zahl der unnötigen Prostatabiopsien erheblich reduzieren: Die Hälfte der Männer, die in einer finnischen Studie eine Biopsie benötigten, hatte einen hochgradigen Tumor.

Harnwegsinfektprophylaxe: Es geht auch ohne Antibiotika

20.04.2024 EAU 2024 Kongressbericht

Beim chronischen Harnwegsinfekt bei Frauen wird bisher meist eine Antibiotikaprophylaxe eingesetzt. Angesichts der zunehmenden Antibiotikaresistenz erweist sich das Antiseptikum Methenamin-Hippurat als vielversprechende Alternative, so die Auswertung einer randomisierten kontrollierten Studie.

Update Urologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Purpose

Evidence acquisition

Evidence synthesis

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 5/2020

How to improve patient selection for neoadjuvant chemotherapy in bladder cancer patients candidate for radical cystectomy and pelvic lymph node dissection

Lessons learned from clinical outcome and tumor features of patients underwent selective artery embolization due to postoperative bleeding following 2076 partial nephrectomies: propensity scoring matched study

Feasibility of adopting retroperitoneal robotic partial nephrectomy after extensive transperitoneal experience

Letter to the Editor regarding the article “Meta-analysis of efficacy and safety of continuous saline bladder irrigation compared with intravesical chemotherapy after transurethral resection of bladder tumors”

The utility of vaginal erbium: YAG laser in the treatment of overactive bladder syndrome is in need of confirmation