Outcomes of aquablation: pooled analysis from the WATER, WATER II, OPEN WATER, FRANCAIS WATER, and JAPAN PMS studies

Purpose: Aquablation is a novel surgical technique for the treatment of benign prostatic hyperplasia (BPH).This analysis consolidates data from five international studies—WATER, WATER II, OPEN WATER, FRANCAIS WATER, and JAPAN PMS—to evaluate the long-term efficacy and safety of Aquablation. Methods: Data from 528 patients with symptomatic BPH were pooled from five prospective, multinational studies. Outcomes included International Prostate Symptom Score (IPSS), quality of life (QoL), peak urinary flow rate (Qmax), and post-void residual volume (PVR). Measurements were recorded at baseline and at 1-, 3-, 6-, and 12-months post-procedure. Results: At baseline, patients had a mean age of 67.8 ± 7.7 years and a mean prostate volume of 71.7 ± 32.0 mL (range 20-242 ml). The mean IPSS decreased significantly from 21.5 ± 7.3 at baseline to 5.8 ± 5.0 at 6 months and stabilized at 6.6 ± 5.5 by 12 months. QoL scores improved from 4.7 ± 1.2 at baseline to 1.4 ± 1.5 at 6 and 12 months. Qmax increased from 8.1 ± 5.0 mL/s to 19.0 ± 11.1 mL/s at 3 months and 20.5 ± 11.0 mL/s at 12 months. PVR decreased from 105.9 ± 106.9 mL at baseline to 53.1 ± 68.1 mL at 12 months. Voided volume improved from 197.5 ± 101.9 mL at baseline to 271.9 ± 151.9 mL at 12 months. Conclusion: Aquablation demonstrates sustained improvements in BPH symptoms, quality of life, and urodynamic parameters over a 12-month period. This analysis supports Aquablation as a safe and effective treatment for BPH.