Two-Year Outcomes After Aquablation Compared to TURP: Efficacy and Ejaculatory Improvements Sustained

Peter Gilling, Neil Barber, Mohamed Bidair, Paul Anderson, Mark A. Sutton, Tev Aho, Eugene Kramolowsky, Andrew Thomas, Barrett Cowan, Ronald P. Kaufman, Andrew Trainer, Andrew Arther, Gopal Badlani, Mark Plante, Mihir Desai, Leo Doumanian, Alexis E. Te, Mark DeGuenther, Claus Roehrborn

Research output: Contribution to journalArticlepeer-review

45 Scopus citations


Introduction: To compare 2-year safety and efficacy outcomes after Aquablation or transurethral resection of the prostate (TURP) for the treatment of lower urinary tract symptoms related to benign prostate hyperplasia (BPH). Methods: One hundred eighty-one patients with BPH were assigned at random (2:1 ratio) to either Aquablation or TURP. Patients and follow-up assessors were blinded to treatment. Assessments included the International Prostate Symptom Score (IPSS), Male Sexual Health Questionnaire (MSHQ), International Index of Erectile Function and uroflow. The focus of analysis was 2-year outcomes. Results: At 2 years, IPSS scores improved by 14.7 points in the Aquablation group and 14.9 points in TURP (p =.8304, 95% CI for difference − 2.1 to 2.6 points). Two-year improvements in maximum flow rate (Qmax) were large in both groups at 11.2 and 8.6 cc/s for Aquablation and TURP, respectively (p = 0.1880, 95% CI for difference − 1.3 to 6.4). Sexual function as assessed by MSHQ was stable in the Aquablation group and decreased slightly in the TURP group. At 2 years, PSA was reduced significantly in both groups by 0.7 and 1.2 points, respectively; the reduction was similar across groups (p = 0.1816). Surgical retreatment rates after 12 months for Aquablation were 1.7% and 0% for TURP. Over 2 years, surgical BPH retreatment rates were 4.3% and 1.5% (p = 0.4219), respectively. Conclusion: Two-year efficacy outcomes after TURP and Aquablation were similar, and the rate of surgical retreatment was low and similar to TURP. Trial Registration: no. NCT02505919. Funding: PROCEPT BioRobotics.

Original languageEnglish (US)
Pages (from-to)1326-1336
Number of pages11
JournalAdvances in Therapy
Issue number6
StatePublished - Jun 1 2019


  • Aquablation
  • BPH
  • Robotic surgery
  • TURP
  • Urology

ASJC Scopus subject areas

  • Pharmacology (medical)


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