PD21-05 SINGLE-CENTER EXPERIENCE UTILIZING SECOND GENERATION AQUABEAM SYSTEM FOR THE TARGETED, HEAT-FREE REMOVAL OF PROSTATE TISSUE, DURING THE TREATMENT OF BPH

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology I1 Apr 2016PD21-05 SINGLE-CENTER EXPERIENCE UTILIZING SECOND GENERATION AQUABEAM SYSTEM FOR THE TARGETED, HEAT-FREE REMOVAL OF PROSTATE TISSUE, DURING THE TREATMENT OF BPH Mihir Desai, Abhishek Laddha, Shashikant Mishra, Mahesh Desai, Ravindra Sabnis, and Abhishek Singh Mihir DesaiMihir Desai More articles by this author , Abhishek LaddhaAbhishek Laddha More articles by this author , Shashikant MishraShashikant Mishra More articles by this author , Mahesh DesaiMahesh Desai More articles by this author , Ravindra SabnisRavindra Sabnis More articles by this author , and Abhishek SinghAbhishek Singh More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1472AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We previously reported on our initial clinical experience in 9 patients using the first generation minimally invasive waterjet therapy (Aquabeam, Procept Biorobotics) for the athermal, targeted removal of prostate adenoma. Herein, we report the initial clinical series using the second generation AquaBeam System in patients with lower urinary tract symptoms secondary to BPH. METHODS The second generation platform maintains the primary functionality of the high-velocity saline stream for ablation of the prostatic adenoma. Modifications were made to streamline the procedure including the integration of the ultrasound image directly into the AquaBeam planning unit and cystoscopy in the handpiece, the addition of an integrated pump for active aspiration, and the elimination of laser cautery. In this study, men over 50 years of age with an International Prostate Symptom Score (IPSS) greater than 12, a maximum flow rate of 15 ml/sec, and a prostate volume of 25 – 100 ml were treated. Clinical parameters and safety are assessed out to 1 year after surgery. RESULTS Twenty males with symptomatic BPH were enrolled and treated under spinal or general anesthesia. Monitored data are available on all twenty males treated with seventeen patients now followed through six months. The mean age was 66 ± 6 years with a mean prostate size of 40 ± 18 ml (range of 23 – 91), mean PSA of 2.7 ± 2.5 µg/L and the presence of a median lobe in 7 of the twenty (35%) patients. All procedures were technically successful and no cautery was required in any of the cases with a mean total operative time of 31 ± 8 minutes and Aquablation resection time of 4 ± 3 minutes. There were no intra-operative complications and adverse events were typically mild and transient. At six month follow up, IPSS reduced from 24.1 to 4.6, QoL from 4.7 to 0.2, PVR from 82 to 16 ml, and Qmax improved from 6.9 to 15.2 ml/sec from baseline. Prostate volume and PSA reduced to 23 ml and 1.49 µg/L, respectively, at six month from baseline. There were no procedure related cases of retrograde ejaculation, urinary incontinence, or erectile dysfunction. CONCLUSIONS The functional results of this single-center experience are promising and demonstrated procedural improvements in mean operative and Aquablation times when compared to our initial clinical experience. The clinical and procedural outcomes observed during this clinical experience support further research in a prospective randomized controlled clinical trial. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e458 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Mihir Desai More articles by this author Abhishek Laddha More articles by this author Shashikant Mishra More articles by this author Mahesh Desai More articles by this author Ravindra Sabnis More articles by this author Abhishek Singh More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...