A high-pressure water jet may be an effective and safe option for reducing an enlarged prostate, according to preliminary results of an ongoing Phase 2 clinical trial.
Use of the jet is known as the Aquablation procedure. Doctors guide the jet to the tissue they want to reduce with an image-guided system known as an AQUABEAM.
Trials to evaluate the effectiveness and safety of the Aquablation procedure have been conducted in the United States, Europe, Australia and New Zealand.
Aquablation’s ability to reduce the symptoms of benign prostatic hyperplasia (BPH), or enlarged prostate, were measured three and six months after treatment. Patients will be followed for up to three years to collect long-term data.
The study. “Aquablation Of The Prostate For Symptomatic Benign Prostatic Hyperplasia: One-Year Results,” was published in the Journal of Urology.
The results covered the first year of the trial in 21 Australian and New Zealand BHP patients who had moderate to severe lower urinary tract symptoms (LUTS). The mean age of the patients was 69.7.
Researchers used the International Prostate Symptom Score (IPSS) to assess Aquablation’s ability to improve symptoms. They also checked prostate size with transrectal ultrasound, bladder pressure, and urine flow.
The Aquablation procedure averaged 38 minutes. All patients except one had a catheter for only one day, and 19 of the 21 were discharged a day after the procedure.
Six months after Aquablation, the men’s average bladder pressure had decreased from 65 cmH20 to 39 cmH20. A year after the procedure, their prostate volume had decreased from 57 ml to 35 ml, and their maximum urinary flow had risen from 8.7 mL/sec to 18.3 mL/sec. Also at one year, the men’s mean IPSS score had improved from 23.0 to 6.8.
There were no reports of significant adverse events during the procedure. Importantly, no patient experienced urinary incontinence or sexual dysfunction during the follow-up period — outcomes that can occur with other BPH treatments, such as TURP prostate-reduction surgery.
Researchers believe the way the water-jet works, as opposed to surgery, accounted for its safety and the absence of post-operation complications.
“Potential benefits of the aquablation system used (AQUABEAM) include precise surgical mapping with preservation of key anatomic structures while removing substantial prostate glandular tissue,” they wrote. “Preservation of anatomic landmarks (e.g., bladder neck and some tissue around verumontanum) may contribute to preservation of sexual function by avoiding destruction of the bladder sphincter.”
Together, the results support the notion that Aquablation is a safe option for alleviating BPH symptoms.