Mp51-02 aquablation postoperative bleeding risk reduction

You have accessJournal of UrologyCME1 Apr 2023MP51-02 AQUABLATION POSTOPERATIVE BLEEDING RISK REDUCTION Dean Elterman, Steven A. Kaplan, Lori Lerner, Brian Helfand, Mihir Desai, Neil Barber, Rick Popert, Philip Charlesworth, and Thorsten Bach Dean EltermanDean Elterman More articles by this author , Steven A. KaplanSteven A. Kaplan More articles by this author , Lori LernerLori Lerner More articles by this author , Brian HelfandBrian Helfand More articles by this author , Mihir DesaiMihir Desai More articles by this author , Neil BarberNeil Barber More articles by this author , Rick PopertRick Popert More articles by this author , Philip CharlesworthPhilip Charlesworth More articles by this author , and Thorsten BachThorsten Bach More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003299.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Aquablation was originally studied in two FDA clinical trials spanning the years of 2015-2017 (WATER in prostates ≤80 mL, WATER II in prostates ≥80 mL). Aquablation was granted approval by FDA in December of 2017. Since then, commercial users have adopted a refined focal cautery approach for hemostasis. METHODS: Consecutive, commercial patients undergoing Aquablation from Asia, Europe, and North America were evaluated for bleeding risk of transfusion and takeback over the last 4 years. The source for the reported bleeding events was the FDA MAUDE database that requires manufactures to report global incidents. RESULTS: 13,447 Aquablation cases were performed with a mean prostate size of 90 mL (range 12 to 535 mL). Following the introduction of the focal bladder neck cautery protocol in January 2020, Figure 1 demonstrates a remarkable decline in bleeding risk requiring an intervention (either a transfusion, takeback for cautery, or takeback for clot evacuation). In 2021 and 2022, the risk of transfusion has reduced to 0.3% and 0.2%, respectively. CONCLUSIONS: Aquablation has leveraged imaging and robotics to allow surgeons to treat the a broad range of prostate sizes. However, early learnings in the development of the procedure, surgeons realized a standardized hemostasis technique was nececessry. Following the adoption of the standardized protocol, the bleeding risk has been reduced by 10-fold and allowing some surgeons the option of day-case Aquablation. Source of Funding: Not applicable © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e692 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Dean Elterman More articles by this author Steven A. Kaplan More articles by this author Lori Lerner More articles by this author Brian Helfand More articles by this author Mihir Desai More articles by this author Neil Barber More articles by this author Rick Popert More articles by this author Philip Charlesworth More articles by this author Thorsten Bach More articles by this author Expand All Advertisement PDF downloadLoading ...