ArticleWorld journal of urology2026
Real-World outcomes of aquablation for benign prostatic hyperplasia: a comparative analysis of the international collaborative aquablation research urology society (ICARUS) database, WATER and WATER-II trials.
Article in World journal of urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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Who cites it
2 citing papers in PubMed.
- Phase-specific workflow maturation during early institutional implementation of Aquablation for benign prostatic hyperplasia: a retrospective single-center study.Journal of robotic surgery · 2026Article
- Aquablation for dual burden disease - BPH and chronic prostatitis/chronic pelvic pain syndrome: a single-center prospective pilot study.BMC urology · 2026Article
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Authors and funding
13 authors.
Funding
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Abstract
purposeThe WATER and WATER-II clinical trials of Aquablation demonstrated effectiveness for treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia (BPH) in men with prostate volumes (PV) 30–80 and 80–150 mL, respectively. In this study, we compare real-world Aquablation outcomes of men with similar PVs to results from WATER/WATER-II.
methodsWe retrospectively analyzed 1946 consecutive men from the International Collaborative Aquablation Research Urology Society (ICARUS) database between 2018 and 2024 with PV ≤ 150 mL who underwent Aquablation at one of four international centers. Baseline characteristics, functional outcomes and complications were compared to data from WATER/WATER-II using ANOVA and Kruskal-Wallis tests.
resultsFrom the ICARUS database, 1069 men (PV ≤ 80 mL) were compared to 116 men (WATER), and 877 men (PV 80–150 mL) were compared to 101 men (WATER-II). As expected, there were slight differences in baseline characteristic between cohorts. Quality of Life and International Prostate Symptom Scores (IPSS) were slightly higher at some timepoints in the real-world (E.g. IPSS at 3-months: ICARUS-I 9.9 ± 6.9 vs. WATER 7.0 ± 5.7, p < 0.001). Anejaculation rates, Qmax flow rates, and post-void residuals at 3 months were consistent across cohorts. Transfusion rates were significantly lower in the real-world large prostate dataset (ICARUS-II 1.3% vs. WATER-II 5.9%, p = 0.01).
conclusionReal-world outcomes of Aquablation are broadly comparable to those observed in the pivotal WATER/WATER-II trials. These findings support its generalizability and effectiveness beyond the rigorous selection criteria of WATER/WATER-II, validating its role as a viable treatment for BPH in routine clinical practice.
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Registered trials
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