Water ablation’s safety, efficiency in BPH assessed
Minimally invasive water jet therapy (Aquablation) for the targeted removal of prostate tissue was safe and feasible in follow-up to 12 months in a multicenter clinical trial of men with lower urinary tract symptoms secondary to BPH.
In 57 men with a mean prostate size of 48 mL, no significant intraoperative complications occurred with image-guided water jet therapy, and procedural success was 100%, said first Peter Gilling, MD, at the AUA annual meeting in San Diego.
The results “suggest that it’s a promising new technology,” he said. “Compared to freehand techniques, there’s no real technical difficulty because it’s all done in the set-up, and the procedure is much more reproducible. It’s almost urologist-free. In fact, some of the best procedures… have been done by the engineers.”
The Aquablation System (PROCEPT BioRobotics) combines image guidance and robotics for targeted removal of prostate tissue. A high-velocity saline stream (AquaBeam) is generated using water jets driven by a high-pressure pump. The stream creates a cavity in prostatic glandular tissue without the production of heat. The flow rate generated by the pump (up to 10,000 PSI) dictates the depth of the stream’s penetration.
The procedure is performed using real-time transrectal ultrasound image guidance, which allows conformal planning of the target region of the prostate to be treated. The target tissue contour and depth are programmed into the system by the surgeon.
To obtain hemostasis, a low-power blue laser beam is captured in a low-pressure water column to perform surface coagulation of the fossa.
The 57 patients in the study were treated at four sites. The mean prostate size treated was 48 mL, with a maximum of 102 mL. About half (46%) of the men had a median lobe.