Objective: To compare the outcomes of Aquablation in 30–80 mL prostates with those in 80–150 mL prostates. Surgical options, especially with short learning curves, are limited when treating large prostates for lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). Aquablation (AquaBeam System, PROCEPT BioRobotics Inc., Redwood City, CA, USA) could solve this issue with global reproducibility, independent of prostate volume. Patients and Methods: Waterjet Ablation Therapy for Endoscopic Resection of prostate tissue (WATER [W‐I]; NCT02505919) is a prospective, double‐blind, multicentre, international clinical trial comparing Aquablation and transurethral resection of the prostate (TURP) for the treatment of LUTS/BPH in prostates between 30 and 80 mL. WATER II (W‐II; NCT03123250) is a prospective, multicentre, single‐arm international clinical trial of Aquablation in prostates between 80 and 150 mL. We compare baseline parameters and 12‐month outcomes in 116 W‐I and 101 W‐II study patients. Students’ t ‐test or Wilcoxon tests were used for continuous variables and Fisher’s test for binary variables. Results: The mean (SD) operative time was 33 (17) and 37 (13) min in W‐I and W‐II, respectively. Actual treatment time was 4 and 8 min in W‐I and W‐II, respectively. The mean change in the International Prostate Symptom Score was substantial averaging (at 12 months) 15.1 in W‐I and 17.1 in W‐II ( P  = 0.605). By 3 months, Clavien–Dindo grade ≥II events occurred in 19.8% of W‐I patients and 34.7% of W‐II patients ( P = 0.468). Conclusion: Aquablation clinically normalises outcomes between patients with 30–80 mL prostates and patients with 80–150 mL prostates treated for LUTS/BPH, with an expected increase in the risk of complications in larger prostates. Long‐term outcomes of procedure durability are needed.

Physicians are increasingly utilizing digital health technologies (DHT) such as smartphone applications, network-enabled wearable devices, web-based communication platforms, videoconferencing, chatbots, artificial intelligence and virtual reality to improve access to, and quality of, care. DHT aid in cancer screening, patient education, shared decision-making, promotion of positive health habits, symptom monitoring and intervention, patient–provider communication, provision of psychological support and delivery of effective survivorship care. This narrative review outlines how physicians may utilize digital health to improve or augment their delivery of cancer care. For the full potential of DHT to be realized, experts must develop appropriate solutions to issues surrounding the regulation, liability, quality, security, equity and reimbursement of DHT.

Background Several centers have reported their experience with single-port robotic partial nephrectomy (SP-RAPN) however, it is uncertain if utilization of this platform represents an improvement in outcomes as compared to multiport robot-assisted partial nephrectomy (MP-RAPN). To evaluate this, we performed a meta-analysis to compare the perioperative, oncological, and functional outcomes between SP-RAPN and MP-RAPN. Methods For relevant articles, three electronic databases, including PubMed, Scopus, and Web of Science, were searched from their inception until January 1, 2023. A meta-analysis has been reported in line with PRISMA 2020 and AMSTAR Guidelines. The odds ratio (OR) and weighted mean difference (MD) were applied for the comparison of dichotomous and continuous variables with 95% confidence intervals (CI). Results Of the 374 retrieved abstracts, eight studies were included in the final analysis, comprising a total cohort of 1,007 cases of robot-assisted partial nephrectomy (453 SP-RAPN cases and 554 MP-RAPN cases). Compared to MP-RARP, the SP-RAPN group had a significantly longer ischemia time (MD = 4.6 minutes, 95% CI 2.8 to 6.3, p<0.001), less estimated blood loss (MD = -12.4 mL, 95% CI -24.6 to -0.3, p=0.045), higher blood transfusion rate (OR = 2.97, 95% CI 1.33 to 6.65, p=0.008), and higher postoperative eGFR at 6 months (MD = 4.9 mL/min, 95% CI 0.2 to 9.7, p=0.04). There were no significant differences in other outcomes between the two approaches, including the intraoperative complication, minor postoperative complication (Clavien-Dindo I-II), major postoperative complication (Clavien-Dindo III-V), conversion to radical nephrectomy, pain score at day #1, pain score on discharge, morphine milligram equivalent (MME) usage, hospital stay, positive surgical margins and postoperative eGFR. Conclusions Initial studies have demonstrated that SP-RAPN is a safe and feasible approach to performing partial nephrectomy, albeit with inferior outcomes for ischemia time and blood transfusion rates.