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Informative value of histological assessment of tissue acquired during aquablation of the prostate

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Abstract

Purpose

To determine the histological validity of the tissue acquired during aquablation of the prostate.

Patients and methods

Prostatic tissue of 12 patients that consecutively underwent aquablation for benign prostatic enlargement was systematically examined. Histological examination was performed by two experienced uropathologists using a digital slide scanner and slide viewer software (Pannoramic 250 and Case Viewer 2.3, 3D Histech, Hungary). The surface areas of the assessable glands were examined and set in relation to the total surface area of the material available for histology and to the patient’s total prostate volume. Examinations were performed analogously in ten consecutive patients undergoing transurethral resection of the prostate (TURP) to facilitate interpretation of the results. Data were analyzed using descriptive statistics.

Results

A median of 4.06% (range 1.43–7.5%) of the preoperative total prostate volume (median 64.5 ml (range 40–80 ml)) was obtained for histological examination by aquablation. Due to severe mechanical destruction and fragmentation, only a proportion of 0.43% (0.06–1.79%) of this tissue represented histologically assessable glands. Therefore, roughly 0.017% of the total prostatic volume was available for a reliable histological examination. In comparison, 32.5% (6.67–37.5%) of the total prostate volume was removed by TURP and 22.86% (7.45–40.57%) of this tissue represented informative prostatic glands, corresponding to 7.43% of the total prostate volume.

Conclusion

Histological significance of the tissue obtained by aquablation of the prostate is very limited. Costs and effort of the histological examination must, therefore, be weighed critically against the limited informative value.

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Funding

There was no commercial support.

Author information

Author notes

  1. Gautier Müllhaupt and Annette Enzler-Tschudy contributed equally to this study.

Authors and Affiliations

  1. Department of Urology, St. Gallen Cantonal Hospital, Klinik für Urologie, Rorschacherstrasse 95, 9007, St. Gallen, Switzerland

    Gautier Müllhaupt, Manolis Pratsinis, Hans-Peter Schmid & Dominik Abt

  2. Department of Pathology, St. Gallen Cantonal Hospital, St. Gallen, Switzerland

    Annette Enzler-Tschudy & Katarina Horg

  3. Institute of Medical Genetics and Pathology, University Hospital of Basel, Basel, Switzerland

    Lukas Bubendorf

Authors
  1. Gautier Müllhaupt
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  2. Annette Enzler-Tschudy
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  3. Katarina Horg
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  4. Lukas Bubendorf
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  5. Manolis Pratsinis
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  6. Hans-Peter Schmid
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  7. Dominik Abt
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Contributions

Protocol/project development: GM, AET, and DA. Data collection or management: GM, AET, KH, and DA. Data analysis: GM, AET, LB, and DA. Manuscript writing/editing: GM, AET, and DA. Critical revision of the manuscript: HPS, LB, and MP.

Corresponding author

Correspondence to Gautier Müllhaupt.

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Conflict of interest

GM: Sub-investigator in several studies on Prostatic artery embolization (PAE) and iTIND®. AET: no disclosures. LB: no disclosures. MP: no disclosures. KH: no disclosures. DA: research support (institutional) by Boston Scientific and Olympus. Principle investigator and sub-investigator in several studies on Prostatic artery embolization (PAE) and iTIND®. HPS: Sub-investigator in several studies on Prostatic artery embolization (PAE).

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

All patients provided written informed consent for data use.

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Müllhaupt, G., Enzler-Tschudy, A., Horg, K. et al. Informative value of histological assessment of tissue acquired during aquablation of the prostate. World J Urol 39, 2043–2047 (2021). https://doi.org/10.1007/s00345-020-03426-2

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  • DOI: https://doi.org/10.1007/s00345-020-03426-2

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