Outcomes of Aquablation in Men With Acute and Chronic Urinary Retention

OBJECTIVE To compare outcomes of Aquablation in men with acute and chronic urinary retention.METHODS We conducted a retrospective review of all men undergoing Aquablation resection of the prostate between May 2021 and August 2022. Men were classified as having acute urinary re-tention if they required either intermittent or indwelling catheter and chronic urinary retention if they had a postvoid residual > 300 mL prior to surgery. We compared success rates and time to passage of trial without catheter as well as complication rates to those with no retention.RESULTS A total of 113 men underwent Aquablation including 28 with acute retention and 16 with chronic retention. Failure of initial void trial was significantly higher in patients with pre-operative urinary retention (40%) and chronic retention with postvoid residual > 300 mL (12.5%) compared to those with no retention (7.2%, P < .001). Among men with acute and chronic retention 98% were voiding spontaneously at a mean 5 months follow-up. There was no difference in utilization of postoperative prostate medications, complications, International Prostate Symptom Score or uroflowmetry among men with acute, chronic, or no retention.CONCLUSION Aquablation is an effective method for treatment of men with urinary retention, with 98% achieving spontaneous voiding regardless of preoperative urodynamic findings. Men in acute retention prior to surgery were more likely to fail their initial void trial, which may support the recommendation for a delayed trial without catheter.