How are you taking part in this consultation?

You will not be able to change how you comment later.

You must be signed in to answer questions

    The content on this page is not current guidance and is only for the purposes of the consultation process.

    Interventional procedure overview of transurethral water-jet ablation for lower urinary tract symptoms caused by benign prostatic hyperplasia

    Closed for comments This consultation ended on at   Request commenting lead permission

    Existing assessments of this procedure

    The American Urological Association published an amendment to its guidance on surgical management of lower urinary tract symptoms attributed to benign prostatic hyperplasia in 2020 (Parsons, 2020). It includes the following statements that are relevant to transurethral water-jet ablation:

    • 'Clinicians should inform patients of the possibility of treatment failure and the need for additional or secondary treatments when considering surgical and minimally invasive treatments for LUTS secondary to BPH. (Clinical Principle).'

    • 'Aquablation may be offered to patients with LUTS attributed to BPH provided prostate volume >30/<80g. (Conditional Recommendation; Evidence Level: Grade C [low certainty]).'

    In 2020, Canada's Drug and Health Technology Agency published a bulletin that built on a 2019 rapid response report on minimally invasive treatments for lower urinary tract symptoms in people with benign prostatic hyperplasia (Topfer, 2020). The bulletin considered 4 treatments: prostatic urethral lift, water-vapour thermal therapy, prostatic artery embolisation and aquablation. The report includes the following summary statements:

    • 'Evidence to date suggests these treatments can improve lower urinary tract symptoms, but, in terms of symptom relief, they may be less effective than conventional treatments, such as transurethral resection of the prostate (TURP).

    • Patients may be willing to accept less effective symptom relief as a trade off for fewer adverse events, shorter recovery time, and less risk of ejaculatory and erectile dysfunction with these less invasive treatments.

    • The availability of less invasive treatment options for BPH may encourage more individuals to undergo treatment for lower urinary tract symptoms.

    • Long-term evidence (beyond 2 and 6 years) on all 4 treatments is still lacking. Head-to-head comparative trials of these newer treatments are also needed.'