Waterjet ablation after failed BPH surgery performed like first-time treatment

Design

Retrospective multicentre database study

Population

1,887 men undergoing waterjet ablation; 109 after prior BPH intervention

Primary outcome

Complications, retreatment and functional outcomes

Effect

No significant differences between salvage and primary groups (all P > 0.05)

An international database of 1,887 consecutive men treated with robotic waterjet ablation for benign prostatic hyperplasia at four centres between 2018 and 2024 compared 109 men with a previous BPH procedure against 1,778 without. Published in BJU International on 7 October 2026.

Prostate volumes were similar (82 vs 78 mL). There were no significant differences in perioperative complications, 30-day readmission, retreatment, sexual function scores, flow rate, post-void residual, symptom score or quality of life. Outcomes did not vary by the type of earlier procedure.

The salvage group was small and the study retrospective, so it was not powered to detect modest differences. The authors' conclusion that the procedure should be offered to all such men goes beyond the data. It supports considering waterjet ablation among options for recurrent symptoms after earlier BPH surgery, where available.

• Consider waterjet ablation as one option for recurrent symptoms after previous BPH surgery
• Counsel that evidence comes from a small retrospective salvage group
• Discuss preservation of ejaculatory function when choosing a salvage procedure
• Reassess with flow studies and imaging before any salvage procedure

Why it matters

Salvage BPH surgery has few comparative data, and patients often worry about continence and sexual function.

Don't overread it

A retrospective series with only 109 salvage cases; no difference does not prove equal outcomes.

Read the rest in the app

You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.

Get Daily Doctor — free

Scan to keep reading on your phone. No account needed to start.