Abstract
Objective:
Aquablation is FDA and NICE approved for treating benign prostatic hyperplasia (BPH). In the UK, increasing surgical elective waiting lists have created the need for HIT list models. We present a tertiary centre experience using Aquablation within a HIT list framework and compare it to standard operating protocol (SOP).
Methods:
A prospective cohort study was performed with 60 patients awaiting bladder outlet surgery. Ten patients were operated using HIT protocol and compared to 50 patients under SOP. We assessed differences in perioperative outcomes and complications, including postoperative follow-up.
Results:
There was a significant decrease in IPSS from 24.92 to 5.93 (p = 0.001) and 93% ejaculation preservation. A significant difference in postoperative Hb decrease was observed, with HIT = 5.3 g/L vs SOP = 12.3 g/L (p < 0.05). No blood transfusions were needed. Operative times were similar, with the HIT group having a median of 56 minutes and the SOP group 59 minutes.
Conclusion:
Our analysis demonstrates that the introduction of Aquablation in a tertiary centre is feasible for managing moderately enlarged prostate glands (80–150 ml). The implementation of a dual operating theatre HIT list using a single Aquabeam robotic system appears to be a viable strategy for increasing surgical capacity. While initial results suggest comparable perioperative outcomes to standard operating protocol, further studies with larger cohorts are required to assess the long-term safety and broader applicability of this approach.
Level of evidence:
3
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