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"Aquabeam® System" for benign prostatic hyperplasia and LUTS: birth of a new era. A systematic review of functional and sexual outcome and adverse events of the technique.
International Journal of Impotence Research ( IF 2.8 ) Pub Date : 2019-06-07 , DOI: 10.1038/s41443-019-0158-3
Giulio Reale 1 , Sebastiano Cimino 1 , Giorgio Bruno 2 , Fabiano Palmieri 2 , Raimondo Giardina 1 , Giorgio Ivan Russo 1 , Enrico Grimaldi 1 , Salvatore Voce 2 , Giuseppe Morgia 1
Affiliation  

Purpose

Aim of this systematic review is to evaluate functional outcomes (Qmax, QoL, IPSS, PVR), sexual outcome (erectile dysfunction and anejaculation rate), and adverse events evaluated according to the Clavien–Dindo classification.

Methods

The bibliographic search with the included terms (prostate, benign prostatic hyperplasia, benign prostatic enlargement, lower urinary tract symptoms, water jet dissection, aquablation, Aquabeam®) produced a literature of 32 articles altogether. After removing papers of not interest or articles which the outcomes could not be deduced, nine studies were examined for a total of 664 patients screened.

Results

The functional outcomes, evaluated after water jet dissection, have shown improvement with respect to the baseline in all the selected articles. In the comparison papers with the TURP, the Aquablation has been statistically not inferior regarding functional outcomes. The sexual outcomes have highlighted a better ejaculation rate for water jet dissection than TURP. Regarding the adverse events, water jet dissection documented low rates of adverse events and, in comparison studies, were not statistically superior than TURP.

Conclusions

In our systematic review, the Aquabeam® System for the treatment of LUTS/BPH has proven to be a safe technique that provides functional outcomes comparable to TURP. About sexual outcomes, the most important data is certainly the low rate of retrograde ejaculation. However, other multicenter randomized trials with larger cohorts and longer follow-up are still needed.



中文翻译:

良性前列腺增生和LUTS的“Aquabeam®系统”:新时代的诞生。对功能和性结果以及该技术不良事件的系统评价。

目的

该系统评价的目的是评估功能结局(Qmax,QoL,IPSS,PVR),性结局(勃起功能障碍和射精率)以及根据Clavien-Dindo分类评估的不良事件。

方法

在书目搜索中包括以下术语(前列腺,良性前列腺增生,良性前列腺肿大,下尿路症状,水射流解剖,aquablation,Aquabeam®),共有32篇文献。在删除了不感兴趣的论文或无法推断出结果的文章后,检查了9项研究,共筛选出664名患者。

结果

水射流解剖后评估的功能结果显示,所有选定文章的基线水平都有改善。在与TURP的比较文件中,Aquablation在功能结果方面在统计学上并不逊色。性结果表明,与TURP相比,射流清扫术的射精率更高。关于不良事件,喷水解剖显示不良事件发生率低,并且在比较研究中,统计学上不优于TURP。

结论

在我们的系统评价中,已证明用于治疗LUTS / BPH的Aquabeam®系统是一种安全的技术,可提供与TURP相当的功能结果。关于性结局,最重要的数据当然是逆行射精率低。然而,仍然需要其他具有更大队列和更长随访时间的多中心随机试验。

更新日期:2019-06-11
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