- Design
- Retrospective international multicentre database analysis
- Population
- 1,887 men having Aquablation, 109 after a previous BPH procedure
- Primary outcome
- Complications, retreatment and functional outcomes
- Effect
- No significant differences in complications, retreatment, IPSS or sexual function (all P > 0.05)
A retrospective analysis of an international four-centre database (BJU International, 7 October) included 1,887 consecutive men who had Aquablation between 2018 and 2024. Of these, 109 (5.8%) had previously undergone a BPH procedure.
Prostate volumes were similar between groups (about 80 mL). There were no significant differences in perioperative complications, 30-day readmission, surgical retreatment or sexual function scores, and improvements in flow rate, post-void residual, IPSS and quality of life were similar. Results did not differ by type of previous procedure.
Men with recurrent symptoms after TURP, laser or minimally invasive treatments often face a harder revision operation. These data suggest Aquablation is a reasonable option in this group. The salvage cohort was small, comparisons were unadjusted, and lack of a statistically significant difference is not proof of equivalence.
- Consider Aquablation as one option for men with recurrent lower urinary tract symptoms after a previous BPH procedure.
- Assess the cause of recurrence, such as regrowth, stricture or bladder dysfunction, before choosing a salvage procedure.
- Counsel men that salvage data are from a small, retrospective series.
- Discuss ejaculatory and continence outcomes, which were similar to first-time treatment in this series.
Why it matters
It widens the options for men whose first BPH operation has not lasted.
Don't overread it
With 109 salvage patients and unadjusted comparisons, the study cannot show the two groups are truly equivalent.
The statistics, in plain English
P-values above 0.05 mean no difference was detected; with a small salvage group, modest differences could have been missed.
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