Department of Urology, Asklepios Hospital Harburg, Eissendorfer Pferdeweg 52, 22559, Hamburg, Germany.
Department of Urology, Kantonspital Frauenfeld, Kanton Thurgau, Switzerland.
World J Urol. 2019 Jul;37(7):1369-1375. doi: 10.1007/s00345-018-2509-y. Epub 2018 Oct 4.
Aquablation of the prostate using the AquaBeam™ system promises equivalent functional outcomes, reduced learning curve, and improved sexual function compared to transurethral prostate resection as shown in prospective randomized trials. This prospective cohort study aims to evaluate if published results can be transferred into the clinical routine in a non-selected patient collective.
This study includes all patients treated between September 2017 and June 2018 with Aquablation of the prostate. Patients have been evaluated prospectively for the perioperative course and early follow-up. Besides voiding parameter and symptom score, TRUS-volume change, ejaculatory function, and adverse events have been recorded.
118 consecutive patients have been treated in the given time. Aquablation could be carried out successfully in all patients. IPSS, QoL, Qmax, and PVR improved significantly after the procedure and continued to improve during 3-month follow-up. Mean OR time was 20 min, TRUS volume decreased by 65%, and 73% of the patients retained antegrade ejaculation. Thirteen adverse events (> Clavien-Dindo I) occurred in 10 patients.
The surgical ablation of the prostate using Aquablation achieved significant and immediate improvement of functional voiding parameters Qmax and PVR as well as symptomatic improvement of IPSS and QoL. Aquablation seems to be safe and effective with a low perioperative complication profile even in a non-selected group of patients.
与经尿道前列腺切除术相比，使用 AquaBeam 系统进行前列腺水刀消融术在预期随机试验中具有相当的功能结果、降低学习曲线和改善性功能。本前瞻性队列研究旨在评估已发表的结果是否可以在非选择性患者群体中转移到临床常规中。
本研究纳入了 2017 年 9 月至 2018 年 6 月期间接受 AquaBeam 前列腺消融术治疗的所有患者。对患者进行了前瞻性评估，包括围手术期和早期随访。除了排尿参数和症状评分外，还记录了经直肠超声体积变化、射精功能和不良事件。
在给定的时间内，118 例连续患者接受了治疗。所有患者均成功进行了水刀消融术。治疗后 IPSS、QoL、Qmax 和 PVR 显著改善，在 3 个月随访期间持续改善。平均手术时间为 20 分钟，经直肠超声体积减少 65%，73%的患者保留了顺行射精。10 例患者发生了 13 例（>Clavien-Dindo I 级）不良事件。
使用 AquaBeam 进行前列腺消融术可显著改善 Qmax 和 PVR 等功能性排尿参数以及 IPSS 和 QoL 等症状，具有即时改善效果。AquaBeam 即使在非选择性患者群体中，也具有较低的围手术期并发症发生率，安全有效。
