Aquablation beneficial in men with urinary retention

Aquablation therapy appears to lead to spontaneous voiding in men with urinary retention, regardless of preoperative urodynamic findings, according to a study.

For the study, researchers identified all men who underwent Aquablation resection of the prostate between May 2021 and August 2022. Medical records of these men were reviewed retrospectively.

Outcomes such as success rates and time to passage of trial without catheter, in addition to complication rates, were evaluated and compared among groups with acute, chronic, and no urinary retention. Acute urinary retention was defined as requirement of either intermittent or indwelling catheter, while chronic urinary retention was defined as postvoid residual (PVR) >300 mL prior to surgery.

The analysis included 113 men who underwent Aquablation, including 28 with acute retention and 16 with chronic retention. Men with preoperative urinary retention and those who had chronic retention with PVR >300 mL were more likely to fail initial void trial compared with those who had no retention (40 percent and 12.5 percent vs 7.2 percent, respectively; p<0.001).

Among men with acute and chronic retention, 98 percent were voiding spontaneously at a mean follow-up of 5 months. No differences in use of postoperative prostate medications, complications, International Prostate Symptom Score, or uroflowmetry were seen among men with acute, chronic, or no retention.

The findings suggest that men with acute retention prior to surgery are likely to fail their initial void trial, which may back the recommendation for a delayed trial without catheter.