Evaluating the outcomes of single-pass versus multiple-pass during aquablation in patients with urinary symptoms due to benign prostatic hyperplasia.

This study evaluated the outcomes of single-pass versus multiple-pass during aquablation in patients with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). The data showed that treatment with multiple passes during aquablation improved the urinary outcomes compared to a single pass in these patients.

Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland. These patients often experience lower urinary tract symptoms (LUTS). These include symptoms such as difficulties emptying the bladder, urine leakage (incontinence), or getting up to urinate during the night. Standard treatments for BPH involve surgical procedures and medications that can often impact ejaculation and sexual function.

Transurethral resection of the prostate (TURP) is the most common surgery used to treat BPH. TURP involves removing some excess prostate tissue to reduce pressure on the urethra (the tube which carries urine from the bladder to outside the body). With very large prostates, TURP carries an increased risk of side effects, such as bleeding or sexual dysfunction.

Aquablation removes enlarged prostate tissue using a strong jet of water which allows for very accurate removal of prostate tissue. This reduces the risk of complications. A single pass with the water jet during aquablation is commonly performed to remove the enlarged tissue. Some surgeons, also use two or more "passes" with the water jet during aquablation to be sure excess prostate tissue is removed. However, the outcomes of single-pass versus multiple-pass during aquablation in patients with LUTS due to BPH remain unclear.

This study analyzed 2 studies and involved 282 patients with BPH. 127 patients received treatment with a single pass during aquablation. 90 patients received treatment with multiple passes during aquablation. 65 patients received treatment with TURP. The International Prostate Symptom Score (IPSS) was measured before and after treatment. This questionnaire can be used to screen for, rapidly diagnose, and track the symptoms of LUTS. Quality of life (QoL), erectile function, maximum urine flow rate, and the volume of urine left in the bladder after urination

Patients who received treatment with multiple passes during aquablation had larger prostates than patients who received treatment with a single pass during aquablation.

Patients who received treatment with multiple passes during aquablation had lower (better) IPSS scores (by ~4 points) and QoL scores (by ~0.7 points) compared to patients who received treatment with a single pass during aquablation.

Patients who received treatment with multiple passes during aquablation had a higher maximum urine flow rate (by ~5 ml/sec) compared to patients who received treatment with a single pass during aquablation.

 There was no significant difference in ejaculatory dysfunction between the two groups.

This study concluded that treatment with multiple passes during aquablation improved the urinary outcomes compared to a single pass in men with LUTS due to BPH.

This study looked back in time at medical records. The patients were not randomly assigned into groups.