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Aquablation — AquaBeam Robotic Waterjet for BPH

Aquablation (AquaBeam Robotic System; Procept BioRobotics) is described by its developers as the first surgical BPH therapy to combine real-time transrectal ultrasound guidance with robotically executed, heat-free, high-velocity saline waterjet ablation of the prostatic adenoma.[1][2][3] It is a tissue-removing option with randomized evidence against TURP in 30–80 mL glands and separate prospective evidence in larger glands.[3][9] Selection turns on ejaculation preservation, bleeding risk, gland size and access to the robotic system. For other BPH options, see BPH & Male LUTS — chooser.

Mechanism of action​

The AquaBeam delivers a high-velocity saline jet (500–8,000 PSI) through a robotically controlled handpiece. The procedure has two phases[1]:

  1. Cutting mode. The surgeon maps the treatment contour on real-time TRUS, defining angle, length, depth and contour. The console then executes the ablation automatically with the high-pressure waterjet.
  2. Hemostasis after ablation. The surgeon assesses the resection bed and controls bleeding. EAU 2026 describes a Foley balloon catheter on light traction, diathermy or low-power laser as needed, and the AUA guideline notes that a limited TURP commonly follows for hemostasis and that focal bladder neck cautery is now a standard part of the procedure.[25][20]

The waterjet preferentially ablates adenomatous tissue while sparing collagenous structures such as the surgical capsule and blood vessels. The ablation itself generates no thermal energy.[1][2][4][25]

The surgeon can define a "veru-protection zone" in the treatment plan that spares the verumontanum and ejaculatory ducts. This is the proposed mechanism for the lower rate of ejaculatory dysfunction compared with TURP.[4][5] At 6 months in WATER, among sexually active men without anejaculation at baseline, anejaculation occurred in 10% after Aquablation.[3]

Procedure​

The procedure is performed under general or regional anesthesia in the OR[1][6]:

  1. Use direct cystoscopic vision for transurethral access.[1] In OPEN WATER, a 24 Fr AquaBeam handpiece was inserted into the prostatic urethra.[36]
  2. In the 2022 standardized procedure, advance the AquaBeam handpiece tip 1–2 cm beyond the bladder neck or intravesical median lobe and secure it to the bed-mounted articulating arm.[37] The 2019 Cochrane review describes a 15 mL handpiece balloon against the bladder neck in an earlier procedure account.[1]
  3. TRUS is performed. The surgeon maps the prostate contour and resection zone on the conformal planning unit (CPU).
  4. The robotic system executes the ablation automatically per plan.
  5. Mean total OR time was 33 min in WATER and 37 min in WATER II; mean Aquablation resection time was 4 and 8 min, respectively. In WATER, TURP resection took 27 min (p < 0.0001 versus the 4-min Aquablation resection time).[3][6]
  6. After ablation, withdraw the handpiece, insert a resectoscope, irrigate clots, clear loose tissue at the bladder neck, and perform focal cautery of bleeding vessels as needed; then place a three-way Foley for irrigation and traction.[11][25] EAU 2026 describes catheter removal before day 2 as commonly achievable, while mean catheter time was 2.0 days in WATER and 3.9 days in WATER II.[25][14]
  7. Mean length of stay was 1.4 days in WATER and 1.6 days in WATER II. In an earlier 15-patient pilot, most men were discharged on postoperative day 1.[6][7][25]

Single vs multi-pass​

In a post hoc analysis of WATER and WATER II, in which the number of passes was not randomized, two or more passes were associated with an IPSS about 4 points lower at 24 and 36 months and a Qmax about 5 mL/s higher at 36 months than a single pass. The multi-pass group had larger prostates, and the difference in ejaculatory dysfunction was not statistically significant.[8]

Patient selection​

WATER and WATER II enrolled different populations[3][9]:

  • Age 45–80 years (WATER).
  • Moderate-to-severe LUTS. WATER excluded active urinary infection, a prior diagnosis of urethral stricture or bladder-neck contracture, PVR > 300 mL, urinary retention at enrollment, catheterization in the 14 days before surgery, or a history of intermittent self-catheterization.[1][38]
  • Prostate volume 30–80 mL in WATER and 80–150 mL in WATER II.[3][9] Use beyond these ranges is reported in real-world series.[3][9][11] WATER III enrolled men with 80–180 mL glands and reported three-month outcomes; current AUA and EAU Aquablation recommendations do not extend above 150 mL.[15][20][25]
  • Obstructing median lobes can be treated, whereas iTIND excludes them. An exploratory WATER subgroup analysis found larger IPSS changes after Aquablation than after TURP in men with enlarged or severely obstructing middle lobes.[12]
  • General or regional anesthesia is required, unlike office-based MISTs.
  • EAU 2026: offer Aquablation for moderate-to-severe LUTS/BPO and a 30–80 mL prostate as an alternative to TURP, particularly for men who want to preserve ejaculation .[25] The EAU summary of evidence rates feasibility above 80 mL as level 2a and calls for additional randomized trials, and WATER II is a single-arm study.[9][25]
  • AUA 2026: clinicians should offer robotic waterjet treatment for prostates of 30–80 cc and may offer it for 80–150 cc . The panel advises considering the larger range only in appropriate patients and with sufficient procedural experience, and gives no guidance above 150 cc because evidence is limited.[20]

Clinical efficacy​

WATER: pivotal RCT vs TURP (30–80 mL)​

WATER randomized 184 men (117 Aquablation, 67 TURP); 181 entered the treated safety cohort.[1][3]

  • Noninferiority was met for IPSS reduction at 6 months.
  • The primary safety endpoint (Clavien-Dindo persistent grade 1 or grade 2 or higher complications) occurred in 26% versus 42% (p = 0.0149). A 2019 Cochrane review of the same trial rated the evidence for major adverse events as very low certainty.[1]
  • At 12 months, IPSS fell by 15.1 points in both groups. Surgical retreatment was 2.6% after Aquablation and 1.5% after TURP (not significant).[13]
  • IPSS and Qmax improvements were maintained at 5 years. Surgical retreatment over 5 years was 5.1% after Aquablation and 1.5% after TURP.[25]

WATER II: large prostates (80–150 mL)​

WATER II was a single-arm prospective study of 101 men[9]:

TimepointIPSSQmax (mL/s)Freedom from retreatment
Baseline23.2 for the 101-patient 12-mo cohort[6]; 22.6 for the 62 five-year completers[9]8.6 in the 5-yr completer analysis[9]—
12 mo6.2 (−17.0)21.1 (+12.5)100%[6]
36 mo6.5 (−16.3)18.5 (+9.8)97%[33]
5 yr (60 visit completers)6.8 (−15.9)17.1 (+9.2)96.3% Kaplan–Meier[9]

A prespecified subgroup analysis using a 100 mL cutoff showed no difference in efficacy outcomes through 5 years.[9]

WATER vs WATER II 5-year comparison​

A cross-trial comparison found similar 5-year outcomes in 30–80 mL and 80–150 mL glands[14]:

OutcomeWATER (30–80 mL)WATER II (80–150 mL)p
IPSS at 5 yr7.06.80.85
Qmax at 5 yr17.317.1 mL/s0.93
BPH-medication-free99%94%0.0517
Freedom from surgical retreatment (5-yr Kaplan–Meier)92.8% KM; 6/116 treated retreated96.2% KM; 3/101 treated retreated0.508 for crude event counts

WATER III: vs laser enucleation (80–180 mL)​

WATER III was an investigator-initiated, nonblinded, partially randomized noninferiority trial with Bayesian analysis. It enrolled 202 men; 186 were treated (98 Aquablation, 88 laser enucleation), and 3-month data were available for 170 (66 randomized, 104 nonrandomized)[15]:

  • IPSS improvement at 3 months: −12.9 (Aquablation) versus −13.1 (laser enucleation); noninferiority probability > 0.999.
  • Clavien-Dindo ≥ 2 or persistent grade 1 complications: 40.8% vs 56.8% (estimated difference −9.4%; 95% credible interval −31.8% to 12.9%).[15]
  • Retrograde ejaculation: 14.8% vs 77.1% (p < 0.001).[15]
  • Persistent stress incontinence: none after Aquablation vs 9.3% after laser enucleation (p < 0.05).[15]

Pooled 5-study analysis​

A pooled analysis of 528 men from WATER, WATER II, OPEN WATER, FRANCAIS WATER and JAPAN PMS reported a mean prostate volume of 71.7 mL (range 20–242 mL). IPSS fell from 21.5 to 6.6 at 12 months, Qmax rose from 8.1 to 20.5 mL/s, and PVR fell from 105.9 to 53.1 mL.[16]

Single-center real-world experience (4 years)​

A prospective single-center observational study of 330 men reported[17]:

  • Mean prostate volume 110.3 mL (range 38–330 mL).[17]
  • IPSS 23.8 to 6.9 and Qmax 6.4 to 17.4 mL/s at 4 years.[17]
  • Prostate volume reduction of 41.3% at 1 year.[17]
  • Antegrade ejaculation preserved in 249 of 250 men (99.6%) with data.[17]
  • Transfusion in 3.3%.[17] A second procedure was needed in 3.9%, including TURP of residual anterior tissue in 3.0%.[17]

Sexual function preservation​

Ejaculatory preservation is the main functional difference from TURP and enucleation[5][18][19]:

  • Bettencourt 2026 systematic review (15 studies, 1,533 patients): antegrade ejaculation was preserved in 72–99.6%, and erectile function remained stable across the reviewed studies.[18]
  • WATER: at 6 months, anejaculation in sexually active men without anejaculation at baseline was 10% with Aquablation versus 36% with TURP (p = 0.0003); later follow-up found better ejaculatory function scores after Aquablation through 5 years.[3][18]
  • WATER II: antegrade ejaculation was maintained in 81% of sexually active men, versus 90% in the smaller glands of WATER (EAU).[6][25]
  • WATER III: retrograde ejaculation 14.8% versus 77.1% with laser enucleation (p < 0.001).[15]
  • Perez 2026: ejaculatory function was preserved in 82.8% of 318 prospectively followed Aquablation patients versus 36% of TURP and 18% of HoLEP patients. The TURP and HoLEP comparators (n = 83 each) came from a retrospective database, and the groups differed in prostate size.[19]

The AUA 2026 guideline directs clinicians to counsel patients with LUTS/BPH considering procedural therapy about potential changes in orgasmic, erectile and ejaculatory function .[20] The veru-protection zone is the proposed mechanism.[4][21]

Safety profile and bleeding​

In WATER, the primary safety endpoint at 3 months occurred in 26% of Aquablation and 42% of TURP patients (p = 0.0149).[3] In WATER's 12-month report, no procedure-related adverse events were recorded from months 6 to 12.[13] De novo incontinence was 2% at 12 months in WATER II.[6]

Bleeding is the principal perioperative safety concern. Rectal perforation has also been reported, including two cases among 192 Aquablation patients at one center; in a separate case report, diagnosis followed nonspecific symptoms on postoperative day 2.[42][43] In a nonrandomized multicenter comparison (75 per arm), postoperative hemoglobin decline was 2.6 g/dL after Aquablation versus 0.4 g/dL after HoLEP, while one patient in each arm required transfusion; follow-up was 6 months.[27]

  • WATER: one transfusion after Aquablation and none after TURP (EAU 2026). The AUA 2026 guideline notes that early studies showed a greater hemoglobin decrease with waterjet treatment than with TURP.[25][20]
  • WATER II (large prostates): the 12-month report recorded postoperative transfusion in 10 of 101 men (10%) and takeback fulguration in 5 (5%).[6] No formalized bladder neck cautery was performed in that study. Standard traction with a limited TUR was associated with less hemoglobin decrease and transfusion than heavier traction or standard traction alone, especially in medium and large prostates, and focal bladder neck cautery is now considered a standard part of the procedure.[20]
  • Post-market data (Bitar 2026): a manufacturer database combined with FDA MAUDE reports covering 70,270 procedures gave a combined rate of transfusion or return to the OR for hemostatic fulguration of 0.2%.[11]
  • A prospective comparative study reported that complication rates declined significantly after the first 30 Aquablation cases.[19]
  • A propensity-matched TriNetX analysis observed more catheter reinsertion within 30 and 90 days after Aquablation than after most comparator BPH operations; prostate volume was not a matching variable.[45]

No Aquablation-specific VTE-prophylaxis recommendation exists; apply the general urologic-surgery risk framework on the VTE Prophylaxis page.

Learning curve​

In a retrospective analysis of 175 consecutive patients treated by three surgeons, the trifecta (operative time < 60 min, hemoglobin reduction ≤ 2 g/dL and no Clavien-Dindo grade ≥ 2 complication within 90 days) was achieved in more than 50% of cases after 4 cases and 70% after 50. The pentafecta, which adds IPSS reduction and ejaculation preservation, exceeded 50% after 38 cases.[21] Hemoglobin drop and ejaculation preservation improved with experience, whereas grade ≥ 2 complications and 3-month IPSS reduction did not depend on it.[21] The 2026 EAU endourology perspective describes a shorter learning curve than HoLEP or AEEP, which it estimates at 50–200 cases.[10]

Follow-up, retreatment and durability​

EAU 2026 gives a weak recommendation to follow up patients after surgery and describes review four to six weeks after catheter removal to assess response and adverse events, including IPSS/ICIQ-MLUTS, uroflowmetry, PVR, and erectile and ejaculatory function.[25]

SourcePopulationSurgical retreatment
WATER (30–80 mL)5 yr5.1% surgical retreatment[25]
WATER II (80–150 mL)5 yr3/101 (3.0%) underwent BPH surgery; 96.3% Kaplan–Meier freedom[9]
Single-center, n = 330Up to 4 yr10/330 (3.0%) underwent TURP for residual anterior tissue (BPH retreatment); separately, 13/330 (3.9%) had any second procedure, including 2 for bleeding and 1 for bladder-neck disruption[17]
Shin 2024 BJU Int network meta-analysis[22]12-mo reintervention rankingRanked 2nd, behind TURP
Akgul 2025 systematic review[23]5 yr4.4–6%

For comparison, the Akgul review reported surgical reintervention of 13.6% for UroLift at 5 years, 11.1% for iTIND at 4 years, and 21% for PAE at 2 years.[23] The Rezūm five-year pivotal trial reported 4.4% surgical retreatment, also reported by EAU 2026; the PINNACLE Optilume BPH report found 3/100 (3%) at 2 years.[25][29] The Akgul review noted that industry sponsorship was high-risk in 65% of the included studies and that follow-up varied.[23] The 2026 EAU endourology perspective describes AEEP as the reference standard for size-independent treatment, with long-term retreatment of about 1–2%.[10]

Aquablation vs AEEP (HoLEP) — key trade-offs​

The 2026 EAU endourology perspective is a narrative review by authors with industry ties, and it summarizes[10]:

ParameterAquablationAEEP / HoLEP
Prostate size range30–150+ mLAny size
Learning curve~ 30–50 cases~ 50–200 cases
5-yr surgical retreatment (narrative-review estimates; not head-to-head)3–8%[10]1–2%[10]
Ejaculatory outcomes72–99.6% antegrade ejaculation after Aquablation across reviewed studies[18]18% preservation in Perez HoLEP cohort[19]; 77.1% retrograde ejaculation after laser enucleation at 3 mo in WATER III[15]
Stress incontinence0% persistent at 3 mo in WATER III[15]9.3% persistent at 3 mo in WATER III; longer-term comparative risk undetermined[15]
AnesthesiaGeneral / regionalGeneral / regional
Tissue for pathologyYesYes

EAU 2026 summarizes a 23-study indirect comparison of Aquablation with HoLEP.[25] In the published analysis, HoLEP had a larger 12-month PVR reduction (mean difference 63.1 mL, 95% CI 39.8–87.3), whereas 12-month IPSS, quality-of-life, and Qmax differences were imprecise; neither the RCT-only nor single-arm analysis established an incontinence difference (RR 1.09, 95% CI 0.09–26.42 and RR 4.48, 95% CI 0.22–168.50, respectively; very-low-certainty evidence).[40]

Comparison with other MISTs​

ProcedureIPSS Δ (12 mo)Qmax Δ (12 mo)Volume rangeMedian lobeSurgical retreatment
Aquablation−15.1 (WATER, 30–80 mL)[13]+10.3 mL/s (WATER, 30–80 mL)[13]30–80 mL in WATER (RCT), 80–150 mL in WATER II (single arm), and 80–180 mL in WATER III (three months, partly randomized)[3][9][15]Treatable3–8% at 5 yr[10]
TURP−15.1[13]+10.6 mL/s[13]up to 80 mL[3]Treatable1.5% at 5 yr (WATER)[25]
HoLEPsimilar to TURPsimilar to TURPAny sizeTreatable1–2%[10]
Optilume BPH−11.5[28]+10.3 mL/s[28]20–80 g[28]Intravesical protrusion included (28/100); median-lobe outcome not separately reported[28]3/100 (3%) at 2 yr[29]
Rezūm−11.6 (121 paired at 12 mo)[35]+5.5 mL/s (112 paired at 12 mo)[35]30–80 mL[35]Treatable[35]4.4% at 5 yr (pivotal trial, EAU 2026)[25]
UroLift−10.8 (L.I.F.T. lateral-lobe cohort; 123 paired at 12 mo)[30]+4.0 mL/s (L.I.F.T. lateral-lobe cohort; 103 paired at 12 mo)[30]30–80 mL[30] (FDA device limit ≤100 mL)[39]; MedLift for OML[31]Treatable with MedLift[31]13.6% (19/140) at 5 yr (L.I.F.T. lateral-lobe cohort)[23][46]
iTIND−9.25 (78 paired at 12 mo, RCT)[34]+3.52 mL/s (55 paired at 12 mo)[34]25–75 mL[34]Excluded[34]11.1% at 4 yr[23]
PAE−11.1 (bothersome-LUTS cohort; 339 with 12-mo IPSS)[32]+5.3 mL/s (same cohort; 46 with 12-mo Qmax)[32]Any sizeTreatable21% at 2 yr[23]

Emerging applications​

Localized prostate cancer with concurrent LUTS. A small prospective study in men on active surveillance (PIRADS ≥ 3 lesions) reported improved IPSS, stable or improved sexual function and a transient rise in circulating tumor cells that lasted less than 2 days. No grade group progression was seen at 6 months. The authors concluded that Aquablation may be a safe option in this setting.[24]

Where Aquablation fits​

In WATER, anejaculation at six months was 10% after Aquablation and 36% after TURP among sexually active men; in WATER III, retrograde ejaculation at three months was 14.8% after Aquablation and 77.1% after laser enucleation.[3][15] Ejaculation-preserving HoLEP modifications reported 70–85% antegrade ejaculation in selected cohorts, without a direct comparison against Aquablation.[41]

  • WATER showed IPSS improvement noninferior to TURP in 30–80 mL glands; WATER II was a separate single-arm study in 80–150 mL glands, and a cross-trial analysis reported similar 5-year outcomes.[3][9][14]
  • Obstructing median lobes are treatable without device modification.
  • A 2026 narrative review cites about 3–8% retreatment at five years after Aquablation and about 1–2% long-term retreatment after AEEP.[10] A separate systematic review pooled five-year reoperation rates of 4.1% after AquaBeam (two studies) and 6.6% after HoLEP (seven studies), including procedures for postoperative complications.[44]
  • The learning curve appears shorter than that of enucleation.

Compared with HoLEP, Aquablation had a smaller 12-month PVR reduction in the published network analysis, while its 12-month Qmax difference was imprecise.[25][40] Separate long-term cohorts report about 3–8% surgical retreatment after Aquablation and 1–2% after AEEP, but WATER III has only 3-month comparative follow-up, so relative long-term durability remains untested.[10][15] Aquablation also requires the AquaBeam robotic system. Limitations versus office-based MISTs (UroLift, Rezūm, iTIND, Optilume BPH) are the need for general or regional anesthesia and an OR setting.[11][26]

See Also​

BPH & Male LUTS — chooser · Prostate Enucleation / HoLEP · Simple Prostatectomy · Optilume BPH · Rezūm · iTIND · UroLift PUL · Prostate Artery Embolization

Podcasts​

Aquablation: Expanding BPH Management Options
BackTable Urology, Ep. 142 (2023) · Ali Kasraeian, Jose Silva
backtable.com

Videos​

Aquablation: Step by Step
El-Hajj A, et al. Urology Video Journal 2022 (CC BY-NC-ND 4.0)
Open source videoRead the article

References​

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2. Petrus Vermeulen L, Ordones FV, Zarrabi AD, Gilling PJ. Making waves: an update on Aquablation. Urol Clin North Am. 2025;52(4):535-545. doi:10.1016/j.ucl.2025.07.009

3. Gilling P, Barber N, Bidair M, et al. WATER: a double-blind, randomized, controlled trial of Aquablation vs transurethral resection of the prostate in benign prostatic hyperplasia. J Urol. 2018;199(5):1252-1261. doi:10.1016/j.juro.2017.12.065

4. Mykoniatis I, Renterghem KV, Sokolakis I. How can we preserve sexual function after ablative surgery for benign prostatic hyperplasia? Curr Drug Targets. 2021;22(1):4-13. doi:10.2174/1389450121666200925143916

5. Albayrak AT, Bulbul MV, Rubez A, Fregonesi A, Serefoglu EC. Sexual and urinary outcomes of minimally invasive surgical therapies for LUTS/BPH: a narrative review. Int J Impot Res. 2026. doi:10.1038/s41443-026-01271-2

6. Bhojani N, Bidair M, Zorn KC, et al. Aquablation for benign prostatic hyperplasia in large prostates (80-150 cc): 1-year results. Urology. 2019;129:1-7. doi:10.1016/j.urology.2019.04.029

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8. Bach T, Barber N, Elterman D, et al. Aquablation outcomes in men with LUTS due to BPH following single versus multi-pass treatments. Urology. 2022;169:167-172. doi:10.1016/j.urology.2022.07.007

9. Bhojani N, Bidair M, Kramolowsky E, et al. Aquablation therapy in large prostates (80-150 mL) for lower urinary tract symptoms due to benign prostatic hyperplasia: final WATER II 5-year clinical trial results. J Urol. 2023;210(1):143-153. doi:10.1097/JU.0000000000003483

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13. Gilling PJ, Barber N, Bidair M, et al. Randomized controlled trial of Aquablation versus transurethral resection of the prostate in benign prostatic hyperplasia: one-year outcomes. Urology. 2019;125:169-173. doi:10.1016/j.urology.2018.12.002

14. Berjaoui MB, Nguyen DD, Almousa S, et al. WATER versus WATER II 5-year update: comparing Aquablation therapy for benign prostatic hyperplasia in 30–80-cm³ and 80–150-cm³ prostates. BJUI Compass. 2024;5(11):1137–1147. doi:10.1002/bco2.430

15. Ritter M, Stein J, Barber N, et al. WATER III: a prospective, partially randomized trial of Aquablation therapy versus transurethral laser enucleation of the prostate for treatment of lower urinary tract symptoms. Eur Urol Focus. 2026;12(2):266-274. doi:10.1016/j.euf.2026.01.006

16. Siqueira MHB, Berjaoui MB, Bhojani N, et al. Outcomes of Aquablation: pooled analysis from the WATER, WATER II, OPEN WATER, FRANCAIS WATER, and JAPAN PMS studies. World J Urol. 2025;43(1):635. doi:10.1007/s00345-025-06033-1

17. Omidele OO, Siegal AS, Roshandel R, Te AE, Kaplan SA. Aquablation at 4-years: real world data from the largest single-center study with associated outcomes follow-up. Urology. 2024;194:216-220. doi:10.1016/j.urology.2024.07.047

18. Bettencourt A, Wu J, Borrell JA, et al. Ejaculatory function after robotic waterjet ablation for the treatment of benign prostatic hyperplasia: a systematic review. Int J Impot Res. 2026;38(2):67-75. doi:10.1038/s41443-025-01087-6

19. Perez D, Mamber A, Pasherstnik M, et al. Aquablation for benign prostatic hyperplasia: a prospective study with comparative analysis of transurethral resection of the prostate and holmium laser enucleation. J Laparoendosc Adv Surg Tech A. 2026;36(1):11-17. doi:10.1177/10926429251393894

20. Goueli R, Badlani GH, Welliver C, et al. Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia (BPH): AUA guideline (2026). Part III: Procedural and surgical management. J Urol. 2026;216(2):161-170. doi:10.1097/JU.0000000000005099

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25. European Association of Urology. EAU Guidelines on the Management of Non-neurogenic Male LUTS. 2026. Official full guideline. See section 5.3.4.a.

26. US Food and Drug Administration. About Manufacturer and User Facility Device Experience (MAUDE) Database. Accessed September 11, 2026.

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28. Kaplan SA, et al. "The PINNACLE Study: A Double-blind, Randomized, Sham-controlled Study Evaluating the Optilume BPH Catheter System for the Treatment of Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia." J Urol. 2023;210(3):500-509. doi:10.1097/JU.0000000000003568

29. Kaplan SA, et al. "Two-year long-term follow-up of treatment with the Optilume BPH catheter system in a randomized controlled trial for benign prostatic hyperplasia (The PINNACLE Study)." Prostate Cancer Prostatic Dis. 2024;27(3):531-536. doi:10.1038/s41391-024-00833-z

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31. Rukstalis DB, et al. "Prostatic Urethral Lift (PUL) for obstructive median lobes: 12 month results of the MedLift Study." Prostate Cancer Prostatic Dis. 2019;22(3):411-419. doi:10.1038/s41391-018-0118-x

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