Presented by: Keng Ng BSc(Med), MBBS, MS, FRCS(Urol), PhD
Frimley Health NHS Foundation Trust

Introduction

Aquablation involving ultrasound guided robotic water jet ablation of the prostate has resulted in significant improvements in management of LUTS in men with enlarged prostates with faster recovery. We have recently successfully performed aquablation as a daycase procedure with same day discharge on selected patients with a return for TWOC a few days later.

Materials

Retrospective data were collected during a period of 5 months (Dec 22- May23)  on 30 patients who had aquablation with same day discharge in the evening of the operation with catheters and retruned for TWOC 3 days later. Patients who were living within local suburbs were consented and counselled for the daycase procedure. Data including preop and post op IPSS, flowmetry, TWOC outcomes were collected.

Results

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30 patients had aquablation as daycase procedure, with median age of 69 years, mean prostate volume 63.3cc (40% trilobar). All patients were discharged on same day with catheters and had successful TWOC 3 days later. Three patients presented with urinary retention about a week later (one clot retention, 2 had acute on chronic retention) while another had urgency and frequency which was managed conservatively. Post op Qmax improved to 22.2mls/s from preop Qmax of 8.65mls/s. Mean preop IPSS score of 22 reduced to only 5 post procedure, with QoL improving from 4.6 preop to 1 (pleased) post op.

Conclusion

This early experience on a small cohort of patients has proven that aquablation can be safely performed as day case procedure. This successful proof of concept for daycase aquablation will enable us to confidently perform aquablation aiming for same day discharge thus reducing the pressures on bed shortages in the NHS hospitals. Ongoing further data collection will enhance our confidence in performing such cases as daycases.

Funding

None

Lead Authors

Neil Barber, MD, FRCS
Frimley Health NHS Foundation trust

Simone Giona, MD
Frimley Health NHS Foundation Trust