WCE 2019: Aquablation for Benign Prostatic Hyperplasia: Early Outcomes from Tertiary Care Center in the Middle East

Abu Dhabi, United Arab Emirates (UroToday.com) Albert El Hajj, MD, from the American University of Beirut, Lebanon, presented his institutional experience using Aquablation for benign prostatic hyperplasia (BPH) at the 37th World Congress of Endourology (WCE). Aquablation is a novel, minimally invasive, heat-free technology recently introduced for the management of BPH. It combines multi-dimensional imaging and autonomous tissue removal robotics to deliver heat-free waterjet to remove enlarged prostate tissue with less risk of complications.

This report included a total of 51 patients who underwent Aquablation for symptomatic BPH between March 2018 and August 2019 at a single institution. Patients were assessed by baseline prostate-specific antigen (PSA), transrectal ultrasound (TRUS), and uroflowmetry and follow up occurred at 3 months post-procedure. Validated questionnaires including international prostate symptom score (IPSS), the 15-question International index of erectile dysfunction (IIEF-15), and Male Sexual Health Questionnaire for assession ejaculatory dysfunction (MSHQ-EjD) were used to evaluate the functional urinary and sexual outcomes at baseline and 3 months follow up.

Patient demographics and clinical preoperative characteristics are demonstrated in Table 1. 


Sixteen percent of patients had postoperative urinary retention, 8% had a capsular perforation which all was managed conservatively and resolved after catheterization.  PSA significantly decreased from mean 4.4 in the baseline to 1.8 at 3 months of follow up. Postvoid residual volume decreased from 270ml to 120ml (Figure 1).

Figure 1. Postoperative functional outcomes at 3 months.


Dr. El Hajj concluded that Aquablation is a safe and reproducible procedure in patients with BPH. It has a low complication profile and provides good functional outcomes. This study reported short term follow-up outcomes including only 3 months and further studies are needed to elucidate the long-term outcomes of Aquablation.

Presented by: Albert El Hajj, MD, Assistant Professor, Department of Urology, American University of Beirut, Lebanon  

Written by: Zham Okhunov, MD, Department of Urology, University of California, Irvine, @ZhamOkhunov, at the 37th World Congress of Endourology (WCE) – October 29th-November 2nd, Abu Dhabi, United Arab Emirates