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Background: Endoscopic prostate surgery is an established treatment for male lower urinary tract symptoms (LUTS) and is recognized to have low mortality rates. We aimed to describe factors that may have contributed to death following endoscopic prostate surgery using data from the Australia and New Zealand Audits of Surgical Mortality (ANZASM). Methods: All urological related deaths reported to ANZASM from January 1 2012 to December 31 2019 were reviewed. Deaths related to endoscopic prostate resection (transurethral resection of prostate – TURP, laser procedures) were included. Peer reviewers identified up to three clinical management issues (CMIs), and these were analysed. CMIs were classified in order of least to most concerning: area of consideration, area of concern and adverse events. Results: Of 1127 total urological deaths, 77 deaths were related to endoscopic prostate surgery (7.0%). Most procedures were monopolar TURP. The mean age of patients was 80.9 years (range 57.0–96.2). Leading causes of death were cardiovascular events 23/77 (29.9%) and respiratory failure 14/77 (18.2%). Assessors identified 39 CMIs in 26/77 (33.8%) patients. Twenty‐three were areas of consideration, nine were areas of concern and seven identified adverse events. The most common CMIs were regarding post‐operative care (14/39) and the decision to operate (13/39). Conclusion: Most deaths did not elicit concerns from the ANZASM peer assessors. However, the main concerns identified were surrounding decision making and rationale for operating. This highlights the importance of clear counselling and documentation during the treatment decision process. [ABSTRACT FROM AUTHOR]

To define lower urinary tract symptoms (LUTS) and their relationship to general practitioner (GP) visits and ethnicity among men in the New Zealand (NZ) population-based Wellington Region Community Prostate Study. In 2001–2002 NZ European, Maori and Pacific Island participants were selected from the Wellington region of NZ. Demographic questions, the International Prostate Symptom Score and yearly GP attendance questions were completed by 862 subjects with no history of prostate cancer. There were no significant differences in LUTS among the ethnic groups ( P = 0.80) but symptom scores were positively correlated with age only for NZ Europeans ( P < 0.001, r = 0.179). Overall, NZ populations have a lower prevalence of LUTS than is evident for ethnic groups in other countries. Pacific Islanders attended the GP more often than both NZ Europeans and Maori. Ethnic differences in age-related urinary symptoms and visits to the GP are important for informing culturally appropriate clinical practice and prostate health promotion with minority groups. [ABSTRACT FROM AUTHOR]

Purpose: We sought to establish the safety and effectiveness of aquablation, a novel, image guided, robotic assisted, water jet tissue ablation technology, for the treatment of benign prostatic hyperplasia., Materials and Methods: We performed a prospective, single arm, multicenter trial at a total of 3 centers in Australia and New Zealand with 1-year followup. Participants were men 50 to 80 years old with moderate to severe lower urinary tract symptoms as determined by urodynamics. All patients underwent aquablation under image guidance. Primary end points included procedural and perioperative safety. The main clinical end point was the change from baseline in I-PSS (International Prostate Symptom Score). Other secondary end points included uroflow measures, prostate volume on transrectal ultrasound and detrusor pressure. Detrusor pressure at maximum flow was only measured at 6 months., Results: A total of 21 men underwent aquablation at a mean age of 69.7 years (range 62 to 78). Prostate volume was 57.2 ml (range 30 to 102). Procedural duration averaged 38 minutes with a mean aquablation treatment time of 5 minutes. All but 1 subject were catheterized for 1 day only and 19 of 21 were discharged home the day after the procedure. Detrusor pressure at maximum flow decreased from 65 cm H 2 O at baseline to 39 cm H 2 O at 6 months (p <0.0027). Prostate volume decreased from 57 ml at baseline to 35 ml (p <0.0001). Mean I-PSS score improved from 23.0 at baseline to 6.8 at 12 months (p <0.0001) and maximum urinary flow increased from 8.7 to 18.3 ml per second (p <0.0001). There were no important perioperative adverse events. No urinary incontinence developed and sexual function was preserved postoperatively., Conclusions: This phase II study provides early evidence to support the safety and effectiveness of aquablation for symptomatic benign prostatic hyperplasia., (Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.)