The impact of previous benign prostatic hypertrophy surgery on water ablation therapy: a comparison of safety and efficacy

You have accessJournal of UrologyCME1 Apr 2023MP76-07 THE IMPACT OF PREVIOUS BENIGN PROSTATIC HYPERTROPHY SURGERY ON WATER ABLATION THERAPY: A COMPARISON OF SAFETY AND EFFICACY Randall Lee, Giovanni Cacciamani, Alireza Ghoreifi, David Ortega Herrera, Michael Eppler, Abhisek Venkat, Marissa Maas, Lizana Maria, Leo Duomanian, Rene Sotelo, Andre Abreu, Mike Nguyen, Inderbir Gill, and Mihir Desai Randall LeeRandall Lee More articles by this author , Giovanni CacciamaniGiovanni Cacciamani More articles by this author , Alireza GhoreifiAlireza Ghoreifi More articles by this author , David Ortega HerreraDavid Ortega Herrera More articles by this author , Michael EpplerMichael Eppler More articles by this author , Abhisek VenkatAbhisek Venkat More articles by this author , Marissa MaasMarissa Maas More articles by this author , Lizana MariaLizana Maria More articles by this author , Leo DuomanianLeo Duomanian More articles by this author , Rene SoteloRene Sotelo More articles by this author , Andre AbreuAndre Abreu More articles by this author , Mike NguyenMike Nguyen More articles by this author , Inderbir GillInderbir Gill More articles by this author , and Mihir DesaiMihir Desai More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003350.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Since its introduction in 2018, Aquablation for lower urinary tract symptoms (LUTS) secondary to benign prostatic hypertrophy (BPH) has expanded its indications, including prostate glands up to 150 cc. Patients who previously underwent BPH interventions with recurrence of LUTS often present with variant anatomy, and a paucity of literature exists on the optimal treatment modality for these patients. Herein, we evaluate the safety and efficacy of Aquablation in patients with previous BPH surgical history. METHODS: A prospectively managed single institutional database of patients with BPH managed with Aquablation was queried from August 2020 to June 2022 for patients who failed previous BPH procedures. Comparison of perioperative outcomes (operative time (OT), estimated blood loss (EBL), hospital length of stay (LOS), catheter duration), complications, and functional outcomes (International Prostate Symptom Score (IPSS)) to patients without prior BPH surgery was performed using Chi-Square and Kruskal Wallis statistical analysis. RESULTS: A total of 146 patients with BPH presented for management with Aquablation. We identified 17 patients with a history of previous BPH procedures with median time since last intervention of 5.5 years. Patients who underwent previous BPH procedures had smaller prostate volumes (88.7 vs 69.7 cc, p=0.01). There was no difference in OT (63.8 vs 68 min, p=0.6), EBL (40.2 vs 38.8 cc, p=0.9), LOS (1.3 vs 1.05 days, p=0.2), or catheter duration (4 vs 4.1 days, p=0.3). We observed no difference in 90 day-post operative complications and no difference in pre or postoperative functional outcomes between cohorts. However, patients with and without previous intervention experienced greater percent and absolute improvements in IPSS scores (51.2% and 22.5% reduction, respectively). CONCLUSIONS: We demonstrate patients with previous BPH interventions remain excellent candidates for Aquablation, with no significant differences in perioperative, post operative, and functional outcomes compared to intervention naïve patients. The utilization of ultrasound for systematic planning for execution of efficient tissue resection, without the risk of injury, makes Aquablation an appropriate treatment following failed BPH procedures. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1093 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Randall Lee More articles by this author Giovanni Cacciamani More articles by this author Alireza Ghoreifi More articles by this author David Ortega Herrera More articles by this author Michael Eppler More articles by this author Abhisek Venkat More articles by this author Marissa Maas More articles by this author Lizana Maria More articles by this author Leo Duomanian More articles by this author Rene Sotelo More articles by this author Andre Abreu More articles by this author Mike Nguyen More articles by this author Inderbir Gill More articles by this author Mihir Desai More articles by this author Expand All Advertisement PDF downloadLoading ...