Department of Surgery, NorthShore University Health System, Evanston, Illinois, USA.
Kasraeian Urology, Jacksonville, Florida, USA.
Can J Urol. 2021 Dec;28(6):10884-10888.
The AUA guidelines for benign prostatic hyperplasia distinguish treatments based upon prostate volume (PV), particularly for very large prostates (> 150 mL). While the clinical outcomes and benefits of Aquablation have been studied for men with average and large prostates, it is unknown whether this technology can be used for very large prostates.
Men with PV > 150 mL undergoing Aquablation were identified retrospectively from four North American hospitals. The surgical times and clinical outcomes of men with very large prostates (> 150 mL) were compared to data from men with average PV ≤ 80 mL (WATER study) and large PV 80 mL-150 mL (WATER II study).
The average PV of men who underwent Aquablation with very large prostates was 209 mL ± 56 (n = 34, range 151-362 mL), large PV 107 mL ± 20 (n = 101, range 80-150 mL) and average PV 54 mL ± 16 (n = 116, range 30-80 mL). For men with PV > 150 mL, baseline IPSS was 19 ± 6. With a mean follow up of 7 ± 9 months, the IPSS improved to 7 ± 5 (p < 0.001). Peak urinary flow rate, Qmax, improved from 7 ± 4 mL/s to 19 ± 5 mL/s (p<0.001). Compared to the two other PV groups, there were no differences in terms of improvements in IPSS, quality of life, or uroflowmetry. There were no reports of transfusions (0%) in the cohort of men with very large prostates.
In the present study, we demonstrate that Aquablation is effective and safe in prostates greater than 150 mL while showing consistent outcomes compared to average and large prostates sizes.
AUA 良性前列腺增生指南根据前列腺体积 (PV) 区分治疗方法，特别是对于非常大的前列腺 (> 150 mL)。虽然已经研究了 Aquablation 对平均和大前列腺患者的临床结果和益处，但尚不清楚该技术是否可用于非常大的前列腺。
从北美四家医院回顾性确定了 PV > 150 mL 接受 Aquablation 的男性。与平均 PV ≤ 80 mL (WATER 研究) 和 80 mL-150 mL 大 PV (WATER II 研究) 的男性数据相比，比较了前列腺体积非常大 (> 150 mL)的男性的手术时间和临床结果。
接受 Aquablation 治疗的前列腺体积非常大的男性的平均 PV 为 209 ± 56 mL(n = 34，范围 151-362 mL)、大 PV 为 107 ± 20 mL(n = 101，范围 80-150 mL)和平均 PV 为 54 ± 16 mL(n = 116，范围 30-80 mL)。对于 PV > 150 mL 的男性，基线 IPSS 为 19 ± 6。平均随访 7 ± 9 个月后，IPSS 改善至 7 ± 5(p < 0.001)。最大尿流率，Qmax，从 7 ± 4 mL/s 提高到 19 ± 5 mL/s(p<0.001)。与另外两个 PV 组相比，IPSS、生活质量或尿流率的改善没有差异。在前列腺体积非常大的男性队列中，没有输血报告 (0%)。
在本研究中，我们证明了 Aquablation 在前列腺大于 150 mL 时是有效且安全的，并且与平均和大前列腺大小的结果一致。
