Complications after Waterablation of the prostate for the treatment of lower urinary tract symptoms in men with benign prostatic hyperplasia

Waterablation is gaining new interest in treating lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). The Aquabeam system uses high-velocity water jets to robotically ablate prostatic tissue under real-time ultrasound guidance, with hemostasis achieved via a catheter balloon tamponade and a novel traction device or electrocautery. The present abstract is focus on the complications of this technique. Waterablation was performed in 36 patients with symptomatic BPH in a multicenter prospective study. Baseline, peri-operative and 1-month urinary function data were collected, including uroflowmetry, international prostate symptom score (IPSS), IPSS-Quality of life (IPS-QoL) and post void residual (PVR).The primary end point was evaluated as complication rates graded by Clavien-Dindo score (CDS). Mean age was 67.5 (SD 1.83), baseline mean IPSS was 20.4 (SD 1.15), baseline mean peak flow was 9.05 (SD 0.65) and mean prostate volume was 85.9 cc (SD 6.08). Complications in 1-day post-operative were none in 25 subjects (67.74%), grade 1 in 5 (16.13%), grade 2 in 5 (12.90%) and grade 3 in 1 patient (3.23%). In particular, we found haematuria in 6 patients (16.67%) and fever in 3 (8.33%) and one urosepsis (2.78%). At the removal of catheter, we found 1 case of stress urinary incontinence (2.78%) and 3 had acute retention of urine (8.33%). We observed only 1 case of re-intervention (2.78%). At 1 month, we found 5 cases of dysuria (19.23%) and 5 cases of medical therapy prescription (19.23%) (4 cases of alpha-blocker and 1 of duloxetine)