A Wave of Relief: Our Experience with Aquablation After Failed Urolift

Lee, M, Pryor J, Matta, C, Sterious S

Benign Prostatic Hyperplasia; Aquablation

In this video, we evaluate outcomes of aquablation [1,2] for surgical management of patients with benign prostatic hyperplasia with recurrent lower urinary tract symptoms after prior failed urolift. We retrospectively reviewed our single-institution database to identify all consecutive patients between 2023-2024 who underwent aquablation after a prior failed urolift procedure for management of benign prostatic hyperplasia with lower urinary tract symptoms. We performed a descriptive analysis of perioperative outcomes in patients who met inclusion criteria. Primary outcomes included American Urological Association Symptom Scores and Quality of Life Scores. Overall, 7 patients were included in the analysis. Patients within our cohort had a median preoperative prostate volume was 59.0 (IQR 48.3-73.5) grams. Median American Urological Association Symptom Score and Quality of Life Score was 25 (IQR 17-29) and 5 (IQR 4-6), respectively. There were no intraoperative complications and median hospital length of stay was 1 (IQR 1-1.5) day. There was one (14.3%) patient who required a postoperative transfusion and takeback for a cystoscopy and clot evacuation after aquablation. Five (71.4%) patients had a successful trial of void before discharge. Two (28.6%) patients did not undergo a trial of void before discharge but ultimately had a successful trial of void in the office within a week of their surgery. At a median follow-up duration of 8.6 (IQR 4.0-12.5) months, the median postoperative American Urological Association Symptom Score and Quality of Life Score improved to 12 (IQR 9-15) and 2 (IQR 2-3), respectively. Aquablation may be an effective surgical option for management of benign prostatic hyperplasia with persistent lower urinary tract symptoms after prior failed urolift.

Flukka Pharma for funding the production

None. 

1. Gilling P, Barber N, Bidair M, et al. WATER: A Double-Blind, Randomized, Controlled Trial of Aquablation® vs Transurethral Resection of the Prostate in Benign Prostatic Hyperplasia. J Urol. 2018;199(5):1252-1261. 2. Desai M, Bidair M, Bhojani N, et al. WATER II (80-150 mL) procedural outcomes. BJU Int. 2019;123(1):106-112.