The WATER study clinical results - a phase III blinded randomized trial of aquablation vs. TURP with blinded outcome assessment for moderate-to-severe LUTS in men with BPH
BAUS ePoster online library. Barber N.
Jun 27, 2018; 211368
Disclosure(s): Honorariums and educational support from Olympus, Neotract, Procept-Biorobotics, Intuitive Surgical
Mr. Neil Barber
Mr. Neil Barber
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Abstract
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Introduction: Early reports of Aquablation for lower urinary tract symptoms due to benign prostatic hyperplasia suggest efficacy similar to that of TURP. We aimed to compare the safety and efficacy vs TURP (T).

Methods: In this randomized, blinded, multi-centre phase III trial, men with moderate to severe LUTS related to BPH were assigned to TURP or Aquablation. Six month outcomes are reported for critical safety and efficacy endpoints.

Results: The mean baseline IPSS score, demographic profile (Table 1), and mean prostate volume were similar in both arms.
In the Aquablation group at 6 months, 26% had a safety endpoint event; in the TURP group, 43% had an event. The difference was -17% thus demonstrating superiority of Aquablation versus TURP. For sexually active men, the anejaculation rates for TURP, Aquablation with cautery, and Aquablation without cautery were 38%, 16%, and 7%, respectively.
Mean IPSS scores decreased from 22.9 at baseline to 5.9 at 6 months in the Aquablation group and from 22.2 at baseline to 6.8 in the TURP group demonstrating non-inferiority. Men with prostate size >50 mL had superior improvements in IPSS after Aquablation compared to TURP (p=.0099).

Conclusions: In patients with LUTS due to BPH, surgical prostate resection using a robotically guided waterjet showed non-inferior symptom relief compared to TURP but with a lower risk of sexual dysfunction. This new semi-automated approach may diminish the need for substantial surgical experience to achieve optimal results.

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