What's New in Aquablation

Transurethral resection of the prostate (TURP) is considered the gold standard for minimally invasive treatment of lower urinary tract symptoms due to benign prostate enlargement of <80 ml. Although durable and effective, TURP carries the risk of significant side effects, including infection and bleeding, and the risk of dilutional hyponatremia. The Aquabeam system uses high-velocity water jets to robotically ablate prostatic tissue under real-time ultrasound guidance, with hemostasis achieved via a catheter balloon tamponade and a novel traction device or electrocautery. In this mini-review, we assess early clinical experience with the device. Short-term outcomes appear to be promising, with significant improvements in urinary symptoms and bother. Operative times have been roughly equivalent to those for TURP, while surgical complication rates have been low. Future studies are required to assess long-term effectiveness. Aquablation is an emerging technology that may provide a reasonable alternative to transurethral resection of the prostate for the treatment of benign prostate enlargement. Short-term outcomes appear promising, although studies with longer-term outcomes are needed to confirm the durability of the results.