Focus of the Report: This report focuses on Aquablation therapy for the treatment of lower urinary tract symptoms (LUTS) in men with benign prostatic hyperplasia (BPH).

Technology Description: Aquablation therapy is a minimally invasive procedure that ablates overgrown prostatic tissue in order to restore patency to the urethral passageway. High-velocity saline is sprayed under robotic guidance in order to ablate only the targeted prostatic tissue while sparing all surrounding tissue.

Controversy: The chief goals of treatment for BPH are the reduction of LUTS and the prevention of disease progression. Initial treatment often provides only modest relief, and > 30% of patients require surgical intervention. Sexual dysfunction—including ejaculatory dysfunction and erectile dysfunction—is a common adverse effect that is experienced by patients following treatment with transurethral resection of the prostate (TURP). Additionally, patients receiving TURP often experience a moderate degree of blood loss that may lead to the need for transfusion. TURP is associated with other complications, including urinary incontinence, bladder neck contractures, urethral stricture, and septic shock. Aquablation therapy represents a less invasive treatment option that may improve symptoms of LUTS, preserve sexual function, and carry a low risk of postoperative complications, perhaps even in men with large prostates.

Key Questions:

  • Is Aquablation therapy effective for treatment of BPH?

  • How does Aquablation therapy compare with surgical or other minimally invasive treatments for BPH?

  • Is Aquablation therapy safe?

  • Have definitive patient selection criteria been identified for Aquablation therapy?

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