Page 8 - CUA Absracts 2022_Fulldraft

2022 CUA Abstracts

pain?” answered on a five-point scale (1=Never, 2=Occasionally, cc/sec, respectively (p=0.552), at 36 months. Improvements in both IPSS
3=Sometimes, 4=Most of the time, 5=All of the time). Responses of 3, 4, and Qmax were immediate and sustained throughout followup. At three
or 5 were considered clinically significant. Descriptive statistics were used years, 98% and 94% of treated patients were BPH medication-free in
to summarize findings, Wilcoxon signed-rank test was used to compare WATER and WATER II, respectively (p=0.038). At three years, 96% and
pre- and postoperative states, and logistic regression was used to evaluate 97% of treated patients were free from surgical retreatment in WATER
the association between genital pain and clinical variables. and WATER II, respectively (p=0.613).
Results: A total of 387 patients completed enrollment, with a mean Conclusions: Three-year followup demonstrates that Aquablation ther-
age of 49.5 years and stricture length of 4.5 cm. Preoperatively, 36.4% apy leads to sustained outcomes, few irreversible complications, and
(141/387) of patients reported genital pain, with overall responses of 5.7% low retreatment rates for the treatment of LUTS/BPH independently of
“all of the time,” 9.8% “most of the time,” 20.9% “sometimes,” 29.7% prostate volume.
“occasionally,” and 33.9% “never.” Patients with panurethral stricture References
reported significantly higher rates (57.1%) of preoperative pain (odds ratio 1. Foster HE, Dahm P, Kohler TS, et al. Surgical management of lower
[OR] 2.93, 95% confidence interval [CI] 1.32–6.50, p=0.008). Overall, urinary tract symptoms attributed to benign prostatic hyperplasia:
pain scores improved post-urethroplasty (p<0.0001), with responses of AUA guideline amendment 2019. J Urol 2019;202:592-8. https://
1.0% “all of the time,” 3.6% “most of the time,” 9.6% “sometimes,” doi.org/10.1097/JU.0000000000000319
21.2% “occasionally,” and 64.6% “never.” Specifically, in those reporting 2. Gravas S, Cornu JN, Gacci M, et al. Management of non-neuro-
preoperative genital pain, 88.7% (125/141) experienced improvement genic male lower urinary tract symptoms (LUTS), incl. benign
(p<0.0001), 8.5% were unchanged, and 2.8% reported worse pain. prostatic obstruction (BPO). Published online 2019. Available at:
On logistic regression analysis patients with penile strictures (OR 0.24, https://researchportal.helsinki.fi/en/publications/management-of-
95% CI 0.06–0.91, p=0.04), hypospadias (OR 0.14, 95% CI 0.02–0.88, non-neurogenic-male-lower-urinary-tract-symptoms-lu. Accessed
p=0.04), and staged reconstruction (OR 0.22, 95% CI 0.05–0.90, p=0.04) November 14, 2021.
were less likely to report improvement in genital pain (80.0%, 76.5%, and 3. Lin Y, Wu X, Xu A, et al. Transurethral enucleation of the prostate
69.2%, respectively). No identifiable clinical factor was associated with versus transvesical open prostatectomy for large benign prostatic
worsening pain. In the entire study cohort, 50.4% reported improvement hyperplasia: A systematic review and meta-analysis of random-
in genital pain after urethroplasty, 37.0% were unchanged, and 12.7% ized controlled trials. World J Urol 2016;34:1207-19. https://doi.
reported worsening pain. In the overall cohort, patients undergoing staged org/10.1007/s00345-015-1735-9
reconstruction were again less likely to report an improvement in genital 4. Kuntz RM, Lehrich K, Ahyai SA. Holmium laser enucleation
pain status (OR 0.49, 95% CI 0.26–0.95, p=0.04), with no factor associ- of the prostate vs. open prostatectomy for prostates greater
ated with worsening of genital pain post-urethroplasty. than 100 grams: 5-year followup results of a randomized clin-
Conclusions: Genital pain is common in patients presenting with urethral ical trial. Eur Urol 2008;53:160-6. https://doi.org/10.1016/j.
stricture and more common in those with panurethral stricture. While the eururo.2007.08.036
exact mechanism remains to be determined, genital pain improves in the 5. Gilling P, Barber N, Bidair M, et al. WATER: A double-blind,
majority of patients undergoing urethroplasty but less so in patients with randomized, controlled trial of Aquablation vs. transurethral
penile strictures, hypospadias, and staged reconstruction. resection of the prostate in benign prostatic hyperplasia. J Urol
2018;199:1252-61. https://doi.org/10.1016/j.juro.2017.12.065
POD-1.4 6. Gilling P, Barber N, Bidair M, et al. Three-year outcomes after
Aquablation therapy compared to TURP: Results from a blinded
WATER vs. WATER II three-year update: Comparing Aquablation randomized trial. Can J Urol 2020;27:10072-9.
therapy for benign prostatic hyperplasia in 30–80 cm and 7. Bhojani N, Nguyen DD, Kaufman RP Jr, et al. Comparison of 100
3
3
80–150 cm prostates cc prostates undergoing Aquablation for benign prostatic hyper-
Anis Assad , David-Dan Nguyen , Kevin Zorn , Dean Elterman , Naeem plasia. World J Urol 2019;37:1361-8. https://doi.org/10.1007/
3
1
2
1
Bhojani 1 s00345-018-2535-9
1 Division of Urology, University of Montreal Hospital Centre (CHUM), 8. Zorn KC, Bidair M, Trainer A, et al. Aquablation therapy in large
Montreal, QC, Canada; Faculty of Medicine, McGill University, Montreal, prostates (80–150 cc) for lower urinary tract symptoms due to
2
QC, Canada; Division of Urology, Department of Surgery, University benign prostatic hyperplasia: WATER II three-year trial results.
3
Health Network, University of Toronto, Toronto, ON, Canada BJUI Compass. Published online October 28, 2021. https://doi.
Some of the results of this abstract were presented at the AUA’s 2021 org/10.1002/bco2.121
annual meeting. Medical and surgical retreatment rates will be presented 9. Nguyen DD, Barber N, Bidair M, et al. WATER vs. WATER II
for the first time. two-year update: Comparing Aquablation therapy for benign
Introduction: Surgical options are limited when treating large (>80 cc) prostatic hyperplasia in 30–80-cm and 80–150 cm prostates.
3
3
prostates for lower urinary tract symptoms (LUTS) due to benign prostatic Eur Urol Open Sci 2021;25:21-8. https://doi.org/10.1016/j.
hyperplasia (BPH). Aquablation therapy, a waterjet ablative proced- euros.2021.01.004a
1,2
ure combining image guidance and robotics, is emerging as a safe and
effective procedure with a short learning curve. We aimed to compare
3-8
the outcomes of Aquablation for small-to-moderate (30–80 cc) prostates POD-1.5
with the outcomes for large (80–150 cc) prostates at three-year followup. Clinical predictors of obstruction in women with chronic lower
Methods: WATER is a prospective, double-blind, multicenter, international urinary tract symptoms following remote urethral sling surgery
clinical trial comparing the safety and efficacy of Aquablation and trans- James Ross , Lidia Avvakoumova , Alaya Yassein , Conrad Maciejewski ,
1
1
2
1
urethral resection of the prostate (TURP) in the treatment of LUTS/BPH Humberto Vigil , Duane R. Hickling 1,3
1
in men 45–80 years old with a prostate of 30–80 cc. WATER II is a pro- 1 Division of Urology, Department of Surgery, University of Ottawa,
5,6
spective, multicenter, single-arm, international clinical trial of Aquablation Ottawa, ON, Canada; Halton Healthcare, Georgetown, ON, Canada;
2
in men with a prostate of 80–150 cc. 7,8 We compare 36-month out- 3 The Ottawa Hospital Research Institute, Ottawa, ON, Canada
comes among 116 WATER and 101 WATER II study subjects undergoing Introduction: Assessment and management of patients with chronic lower
Aquablation. Students’ t-test or Wilcoxon tests were used for continuous urinary tract symptoms following remote urethral sling surgery is not well-
7-9
variables and Fisher’s test for binary variables. defined. The objective of this study was to review patients with chronic
Results: International Prostate Symptom Score (IPSS) scores improved urinary symptoms and a history of urethral sling surgery to determine the
from 22.9 and 23.2 at baseline in WATER and WATER II, respectively, to incidence and clinical predictors of obstruction.
8.0 and 6.5 at 36 months, with 36-month reductions of 14.4 and 16.3 Methods: A single-center, retrospective review was performed on all
points, respectively (p=0.247). At baseline, urinary flow rate (Qmax) was patients referred with >6 months of urinary symptoms and a history of
9.4 and 8.7 cc/sec in WATER and WATER II, improving to 20.6 and 18.5 urethral sling surgery. All patients underwent history, physical exam, cyst-
S6 CUAJ • June 2022 • Volume 16, Issue 6(Suppl1)