Could Water Jet Ablation Replace TURPS?

Aquablation Therapy stands up to scrutiny in new study, suggesting improvement over traditional TURPS procedure for BPH.


The use of high pressure water jets to ablate tissue is not completely new to surgery, having been pioneered in orthopedic and spinal disc surgery in the 90s. Now Procept BioRobotics has applied itself to prostate disease, its AquaBeam® system delivering high safety and efficacy in a newly presented study. The AquaBeam System is the only surgical technology for Benign Prostatic Hyperplasia (BPH) that combines intra-procedural ultrasound imaging and surgical robotics to deliver Aquablation, a waterjet ablation therapy. This enables targeted, controlled, heat-free and immediate removal of prostate tissue for the treatment of lower urinary tract symptoms caused by BPH. By combining traditional cystoscopic visualization with ultrasound imaging, the AquaBeam System provides a real-time multi-dimensional view of the prostate, empowering the surgeon with improved decision making during the procedure.

Presented at the American Urological Association (AUA) Annual Meeting in Boston, the data says use of so-called Aquablation, as delivered by AquaBeam, resulted in a large improvement in patient symptoms, a substantial increase in urinary flow rates and a decreased risk of sexual side effects compared to traditional TURP surgery.

Procept BioRobotics, a Silicon Valley robotics company developed the AquaBeam System, which uses a robotically controlled waterjet to remove prostate tissue without the application of heat. The double blind, prospective, randomized WATER (Waterjet Ablation Therapy for Endoscopic Resection of prostate tissue) study compared Aquablation to TURP in 181 male patients, age 45 to 80 years with urinary symptoms due to BPH, at 17 sites across four countries. As reported by co-principal investigator, Claus Roehrborn, MD, Chair of the Department of Urology at UT Southwestern in Dallas, Texas, the study met its primary endpoints, indicating that surgeons were able to deliver high-quality TURP-like outcomes using Aquablation.

Investigator comments

“With the results in the TURP cohort providing a very strong control group, the WATER Study was able to demonstrate that Aquablation achieves comparable overall outcomes for the subjective and objective efficacy measures with even better results in larger glands,” said Dr. Roehrborn.

“These results indicate that the learning curve with Aquablation is very short in relation to TURP, as a majority of the physicians achieved TURP-like results without any prior experience with Aquablation,” said Co-principal Investigator Peter Gilling, MD, Professor of Surgery at the University of Auckland, Bay of Plenty Clinical School Tauranga. “The combination of image guidance and robotics allows the surgeon to identify critical anatomical landmarks and develop an optimal tissue removal plan that seems to provide predictable and reproducible results.”

Company comments

“This is a significant milestone for Aquablation and Procept BioRobotics in our goal of bettering the lives of men suffering from BPH,” said Nikolai Aljuri, Ph.D, co-founder and chief executive officer at Procept BioRobotics. “The early results of this landmark study challenge the gold standard and suggest that Aquablation could become the treatment of choice offering men a sustained and significant improvement in quality of life with a superior safety profile and reduced risk of sexual side effects.”

Source: PR Newswire

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