Assessing Micturition, Sexual Function, and Endoscopic Outcomes One Year after Aquablation: A Single Center Prospective Study - Beyond the Abstract
This included detailed measurements of the prostatic cavity length and preserved apical tissue using length markers on the flexible cystoscope, offering precise correlations with preoperative transrectal ultrasound (TRUS) data. Additionally, qualitative assessments evaluated the patency of the prostatic urethra, residual tissue, and the preservation of key anatomical landmarks such as the verumontanum and bladder trigone. Our results showed that the prostatic cavity length, measured at a mean of 24 ± 8.2 mm, closely aligned with preoperative transrectal ultrasound estimates, confirming the technique's precision in ablative planning. Moreover, the preserved apical tissue, averaging 9.6 ± 5.3 mm, slightly exceeded preoperative expectations, showcasing the effectiveness of the waterjet’s "protected zone" in safeguarding the sphincter region.
In addition to these quantitative findings, the qualitative assessment of anatomical structures revealed excellent preservation of critical landmarks. The verumontanum, an essential structure for maintaining ejaculatory function, was intact in the vast majority of patients. The bladder trigone and ureteral orifices also remained unaltered, and minimal residual tissue or mucosal irregularities were observed, emphasizing the precision and safety of the procedure.
This novel analysis underscores the technique's precision and its implications for anatomical preservation and surgical efficacy. In fact, the anatomical precision observed in this study correlated directly with the sustained functional benefits of Aquablation. Over a one-year follow-up, patients experienced significant improvements in urinary flow and symptom scores, while ejaculatory function was preserved in 96.3% of cases. Moreover, the detailed endoscopic evaluation conducted in this study highlights the exceptional reliability of Aquablation's semi-automated approach, demonstrating its capability to consistently deliver precise and reproducible surgical outcomes. By combining automated precision with surgeon oversight, Aquablation minimizes variability often seen in manual procedures, even during the learning curve. These findings provide compelling evidence that Aquablation offers a robust, surgeon-friendly tool for achieving both functional efficacy and anatomical preservation, further solidifying its role as a leading innovation in precision urologic surgery.
By establishing the feasibility of detailed in vivo anatomical assessments, this study opens the door to further research into the morphological impacts of Aquablation. Future investigations could incorporate advanced imaging techniques and multicenter data to enhance our understanding of the long-term relationship between anatomical preservation and clinical outcomes. Expanding the cohort size and follow-up period will also provide a more comprehensive evaluation of the technique’s durability and reproducibility.
Written by: Daniele Amparore, Division of Urology, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy.
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