JCU - Abstracts of the BAUS 2018 Scientific Meeting - June 2018 - 72

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P8-6 Age is but a number: greenlight laser
prostatectomy is a safe day surgery operation
for men of 75 years and over
Rintoul-hoad S1, Giona S1, Khan A1, Brown C1,
Catterwell R1, Muir G1
1KIng's College Hospital, London, United Kingdom

The incentive to provide daycase urology, such as
Greenlight XPS™ laser Prostatectomy (PVP) is growing;
yet a growing elderly population leads to questions of
safety and efficacy.
Method: Retrospective analysis of 254 patients undergoing 180W PVP in a single Day Surgery Unit: 2015-17.
Results: 31% patients (78/254) were 75 or over (75-92).
42% (n=33) of over 75s were pre-catheterised; under: 15%
(n=27). 66% of over 75s had >60cc prostate compared to
47% of under 75s. 27% (n=21) of over 75s had t2 comorbidities; under: 13% (n=22). 41% (n=32) of over 75s
took anti-coagulation/ anti-platelets; under: 18% (n= 31).
72% (n=56) of over 75s had daycase PVP; under: 85%
(n=149). Unplanned admission was similar in both groups
(4% vs 3%). Only one patient returned to theatre (85 year
old on anti-coagulation). No patients required blood
transfusion. There were no deaths. 8 patients overall
required some electrosurgical resection due to bleeding
or technical problems; 6 were over 75. 12% (n=9) of over
75s were catheter-free 'day zero'; under: 13% (n=22); both
groups had similar catheter-free rate by day 5 (80%).
Catheter-free status at 3 months was 99%. 14% (n=11) of
over 75s re-attended hospital post-discharge from DSU;
under: 11% (n=19). 3 older patients required re-admission
for infection (1), symptoms (1), AUR (1); under: n=5. 3
months follow-up: mean QOL and IPSS score was the
same. 65% of over 75s PVR<100ml (under: 86%) and 69%
had a Qmax >12mls/s (under: 89%).
Conclusion: The majority of men over 75 can have daycase laser prostatectomy with excellent safety and
efficacy.
P8-7 The WATER study clinical results
- a phase III blinded randomized trial of
aquablation vs. TURP with blinded outcome
assessment for moderate-to-severe LUTS in
men with BPH
Barber N1, Thomas A2, Aho T3, WATER study group
1Frimley Park Hospital, Surrey, United Kingdom, 2Princess of Wales
Hospital, Brigend, Wales, 3Addenbrooke's Hospital, Cambridge, UK

Introduction: Early reports of Aquablation for lower urinary tract symptoms due to benign prostatic hyperplasia
suggest efficacy similar to that of TURP.We aimed to compare the safety and efficacy vs TURP (T).

Journal of Clinical Urology 11(1S)
Methods: In this randomized, blinded, multi-centre phase
III trial, men with moderate to severe LUTS related to
BPH were assigned to TURP or Aquablation. Six month
outcomes are reported for critical safety and efficacy
endpoints.
Results: The mean baseline IPSS score, demographic profile (Table 1), and mean prostate volume were similar in
both arms.
In the Aquablation group at 6 months, 26% had a safety
endpoint event; in the TURP group, 43% had an event. The
difference was -17% thus demonstrating superiority of
Aquablation versus TURP. For sexually active men, the
anejaculation rates for TURP, Aquablation with cautery,
and Aquablation without cautery were 38%, 16%, and 7%,
respectively.
Mean IPSS scores decreased from 22.9 at baseline to 5.9
at 6 months in the Aquablation group and from 22.2 at
baseline to 6.8 in the TURP group demonstrating noninferiority. Men with prostate size >50 mL had superior
improvements in IPSS after Aquablation compared to
TURP (p=.0099).
Conclusions: In patients with LUTS due to BPH, surgical
prostate resection using a robotically guided waterjet
showed non-inferior symptom relief compared to TURP
but with a lower risk of sexual dysfunction.This new semiautomated approach may diminish the need for substantial
surgical experience to achieve optimal results.
P8-7: Table 1
Aquablation

Age
BMI
IPSS
IPSS QoL
MSHQ
SHIM

TURP

P value

N

Mean

SD

N

Mean

SD

117
117
116
116
108
115

66.0
28.4
22.9
4.8
7.4
13.7

7.3
4.1
6.0
1.1
4.1
8.6

67
67
65
65
61
64

65.8
28.2
22.2
4.8
8.2
13.4

7.2
4.5
6.1
1.0
4.0
9.4

0.8596
0.7941
0.4276
0.8009
0.2155
0.8243

P8-8 Chronic urinary retention in the
elderly: outcomes for surgery vs long term
catheterisation
Connell R1, Voss J1, Ramanayake J1
Hampshire County Hospital, Winchester, United Kingdom

1Royal

Introduction: Urinary retention in the elderly is an increasingly common issue. This is the first comparative study
reviewing outcomes for elderly patients treated with long
term catheters (LTC) or surgery for chronic urinary retention (CUR) that is refractory to medical management.



Table of Contents for the Digital Edition of JCU - Abstracts of the BAUS 2018 Scientific Meeting - June 2018

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