4th Annual Jefferson Urology Symposium: Focus on Urinary Incontinence

© The Canadian Journal of Urology TM : International Supplement, August 2021 21 Aquablation of the prostate: a review and update To specifically study the effect of novel BPH surgical techniques on sexual function, Bhojani et al assesses three FDA clinical trials (WATER for Aquablation, LIFT for Urolift, and REZUME II for Rezum) and compared IIEF and MSHQ-EjD scores at 3 years. 19 With regards to MSHQ-EjD scores, Aquablation and Urolift showed a positive change at 3 years, with Rezum showing a negative change in that time frame. None of the interventions studied showed a change in IIEF scores frombaseline at 3years. This groupdemonstratedsimilar results to other authors, showing a positive association between Aquablation and preserved sexual function, specifically with regards to ejaculatory function. Future research While Aquablation has been directly compared to TURP, little research has compared the safety as efficacy of Aquablation to HoLEP. Currently, a prospective, randomized, controlled trial is being undertaken at a Swiss tertiary care center to assess non inferiority of Aquablation compared to HoLEP. 20 This study will be an important comparison, as HoLEP is consider a size independent method for the surgical treatment of BPH per current AUA guidelines. Conclusions Aquablation is one of the novel surgical techniques that has been developed for the treatment of BPH. Current studies report on medium-term follow up for patients undergoing this procedure. Aquablation provides comparable operative times to TURP and shorter operative times to HoLEP while having a similar efficacy and safety profile. Newer data has shown that alleviation of LUTS and preservation of sexual function persisted up to 3 years after the procedure. As the technique continues to becomemore refined and experience further gained, Aquablation will be more widely available and provide a safe and efficacious alternative to TURP and other surgical treatments for the management of LUTS associated with BPH. References 1. Wei JT, Calhoun E, Jacobsen SJ. Urologic diseases in america project: benign prostatic hyperplasia. J Urol 2008;179(5 Suppl): S75-S80. 2. Patel ND, Parsons JK. Epidemiology and etiology of benign prostatic hyperplasia and bladder outlet obstruction. Indian J Urol 2014;30(2):170-176. 3. Parsons JK, Dahm P, Köhler TS, Lerner LB, Wilt TJ. Surgical management of lower urinary tract symptoms attributed to benign prostatic hyperplasia: AUAguideline amendment 2020. J Urol 2020;204(4):799-804. 4. Michalak J, Tzou D, Funk J. HoLEP: the gold standard for the surgical management of BPH in the 21(st) Century. Am J Clin Exp Urol 2015;3(1):36-42. 5. Roehrborn CG, Teplitsky S, DasAK.Aquablation of the prostate: a review and update. 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