Does size matter? A single institution's comparison of Aquablation in prostates greater than or less than 150 mL.

Autor: Ringler R; Oakland University William Beaumont School of Medicine, Rochester, Michigan, USA., Gangwish D; Department of Urology, Corewell Health William Beaumont University Hospital, Royal Oak, Michigan, USA., Horning P; Department of Urology, Corewell Health William Beaumont University Hospital, Royal Oak, Michigan, USA., Kuperus J; Oakland University William Beaumont School of Medicine, Rochester, Michigan, USA., Palmateer G; Oakland University William Beaumont School of Medicine, Rochester, Michigan, USA., Zwaans BMM; Oakland University William Beaumont School of Medicine, Rochester, Michigan, USA.; Department of Urology, Corewell Health William Beaumont University Hospital, Royal Oak, Michigan, USA., Hafron J; Oakland University William Beaumont School of Medicine, Rochester, Michigan, USA.; Department of Urology, Corewell Health William Beaumont University Hospital, Royal Oak, Michigan, USA.; Michigan Institute of Urology, Troy, Michigan, USA., Peters KM; Oakland University William Beaumont School of Medicine, Rochester, Michigan, USA.; Department of Urology, Corewell Health William Beaumont University Hospital, Royal Oak, Michigan, USA.
Jazyk: angličtina
Zdroj: The Prostate [Prostate] 2025 Feb; Vol. 85 (2), pp. 140-147. Date of Electronic Publication: 2024 Oct 15.
DOI: 10.1002/pros.24810
Abstrakt: Background: Surgical management options for lower urinary tract symptoms due to benign prostatic hypertension have remained limited in prostates of large volume. The advent of the Aquablation has created a potential minimally invasive option for treatment in prostates of all volumes. Thus, this study aims to evaluate outcomes and complications of Aquablation in clinical practice based on prostate volume.
Methods: Collected variables included adverse events with Clavien-Dindo classifications, transfusion rates, surgical retreatment rates, continued medication use postoperatively, and International Prostate Symptom Score (IPSS) with Quality-of-Life indicator. Aquablations were stratified by preoperative prostate volume.
Results: One hundred seventy-four men were included in the study. The average postop decrease in IPSS was 10.28, with a 2.02 point decrease in Quality-of-Life at 1 year. Postop increase in peak urinary flow rate was 7.65 mL/s for an average of 16.44 mL/s. Hemoglobin drop average was 1.78 g/dL, but only 2.3% of patients required a transfusion. 12.9% of patients required surgical retreatment. Six months after Aquablation, 22.9% and 12.9% of patients continued taking Alpha-blockers and Androgen receptor inhibitors, respectively. Adverse events occurred in 33 patients (19.0%). Eighteen patients were excluded from secondary analysis due to unrecorded prostate volume, leaving 123 with volumes <150 mL and 33 with volumes ≥150 mL. Groups were comparable with respect to length of stay, adverse events, blood transfusion, IPSS with Quality-of-Life indicator preoperative and postoperative, postop peak urinary flow, and postop alpha-blocker use. Larger prostates had a higher rate of adverse events, retreatment, postop hemoglobin drop, and postop use of finasteride.
Conclusions: Aquablation is a viable treatment option for benign prostatic hyperplasia. Efficacy, safety, subjective outcomes, and adverse event rates were not impacted by prostate volume. However, size does matter as prostates ≥150 mL had higher surgical retreatment rates and postop finasteride use.
(© 2024 Wiley Periodicals LLC.)
Databáze: MEDLINE
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