Page 1 - CUA 2020_Endourology
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2020 CUA ABSTRACTS







       Podium Session 1: Endourology, Nephrolithiasis












       POD-1.1                                                POD-1.1. Table 1A.  Baseline characteristics
       Three-year outcomes after Aquablation compared to TURP:
       Efficacy and ejaculatory improvements sustained        Characteristic                Aquablation   TURP
                                                         3
                                          2
                1
                            1
       Kevin C. Zorn , Naeem Bhojani , Dean S. Elterman , S. Larry Goldenberg ,               n=117      n=67
       Alan I. So , Ryan F. Paterson , Mihir Desai , Roehrborn Roehrborn , Steven   Age, years, mean (SD)  66.0 (7.3)  65.8 (7.2)
                          3
              3
                                   4
                                                    5
       Kaplan , Peter Gilling 6                                Body mass index, mean (SD)    28.4 (4.1)  28.2 (4.5)
            5
       1 Urology, University of Montreal Hospital Center (CHUM), Montreal, QC,
                                                   3
             2
       Canada;  Urology, University of Toronto, Toronto, ON, Canada;  Urology,   Prostate size (TRUS)*, gm; mean (SD)  54.1 (16.2)  51.8 (13.8)
                                              4
       University of British Columbia, Vancouver, BC, Canada;  Urology, UTSW,   Prostate specific antigen, g/dL; mean   3.7 (3.0)  3.3 (2.3)
                           5
       Dallas, TX, United States;  Urology, USC, Los Angeles, CA, United   (SD)
       States;  Urology, University of Auckland, Auckland, New Zealand; ATER2/  Cystoscopy findings
            6
       WATER Study Group
       Introduction: We aimed to compare three-year (last followup of the proto-  Lobes present
       col) safety and efficacy outcomes after Aquablation or transurethral resec-  Lateral lobe only  50 (42.7%)  31 (46.3%)
       tion of the prostate (TURP) for the treatment of lower urinary tract symptoms   Middle lobe only  9 (7.7%)  3 (4.5%)
       (LUTS) related to benign prostate hyperplasia (BPH).      Both lateral and middle     55 (47.0%)  88 (47.8%)
       Methods: A total of 181 patients with BPH were assigned at random (2:1   Degree of middle lobe obstruction
       ratio) to either Aquablation or TURP. Patients and followup assessors at   None       23 (19.7%)  15 922.4%)
       each site were blinded to treatment. Assessments included International
       Prostate Symptom Score (IPSS), Male Sexual Health Questionnaire (MSHQ),   Mild        25 (21.4%)  15 (22.4%)
       International Index of Erectile Function (IIEF), and uroflow.  Moderate               35 (29.9%)  22 (32.8%)
       Results: At three years, IPSS scores improved by 14.2 points in the Aquablation   Severe  14 (12.0%)  7 (10.4%)
       group and 15 points in TURP (p=0.7050, 95% confidence interval [CI] for dif-  Bladder neck obstruction  30 (25.6%)  24 (35.8%)
       ference –3.6 to 5.3 points). Three-year improvements in maximum flow rate   Baseline questionnaires
       (Qmax) were large in both groups at 10 and 9.7 cc/sec for Aquablation and
                                                                IPSS score, mean (SD)        22.9 (6.0)  22.2 (6.1)
                                                                IPSS QOL, mean (SD)           4.8 (1.1)  4.8 (1.0)
                                                                Sexually active, N (%) [MSHQ-EjD]  93 (80.2%)  54 (83.1%)
                                                                MSHQ-EjD mean (SD)**          8.1 (3.7)  8.8 (3.6)
                                                               IIEF-5, mean (SD)**           17.2 (6.5)  18.2 (7.0)
                                                               *Volume = prostate length × width × height × π/6. **Sexually active men only.
                                                             TURP, respectively (p=0.9078, 95% CI for difference –2.9 to 6.4). Sexual
                                                             function as assessed by MSHQ-EjD was stable in the Aquablation group
                                                             and decreased slightly in the TURP group; these changes persisted at year
                                                             three. At three years, prostate-specific antigen was reduced significantly
                                                             in both groups but showed no difference between groups (p=0.4074 for
                                                             difference). The average annual retreatment occurrence was less than 2%
                                                             in both treatment groups.
                                                             Conclusion: Three-year efficacy outcomes after TURP and Aquablation were
                                                             similar and the rate of surgical retreatment was low and similar to TURP.
                                                             Efficacy results have maintained their improvement since the 90-day fol-
                                                             lowup for both groups that are consistent with all other resective surgical
                                                             techniques.
                                                             Trial registration: ClinicalTrials.gov number, NCT02505919
       POD-1.1. Fig. 1. Uroflow measures by treatment and time. For PVR, insert graph
       shows analysis of those with elevated (>100 cc) and not elevated (<100 cc)
       baseline PVR. Black circles=aquablation; gray triangles=TURP. PVR: post-void
       residual; TURP: transurethral resection of the prostate.


                                                CUAJ • June 2020 • Volume 14, Issue 6(Suppl2)                 S23
                                                  © 2020 Canadian Urological Association
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