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Patients were stratified by prostate volume (&lt;\u200980\u00a0cc vs. \u226580\u00a0cc). Baseline characteristics, perioperative parameters, and functional outcomes were assessed using validated instruments, including IPSS, IPSS-QoL, irritative subscore, ICIQ-SF, IIEF-EF, MSHQ-EjD, and MSHQ-bother, at baseline and at 3, 6, 12, and 24 months. Complications were graded according to the Clavien\u2013Dindo classification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 628 men were included (324 with prostates\u2009&lt;\u200980\u00a0cc and 304 with prostates\u2009\u2265\u200980\u00a0cc). Men with larger prostates had higher rates of preoperative catheter dependence (34% vs. 18.2%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Operative time (40.6\u2009\u00b1\u200914.1 vs. 36.2\u2009\u00b1\u200912.6\u00a0min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001) and hospitalization duration (2.5\u2009\u00b1\u20091.5 vs. 2.09\u2009\u00b1\u20090.8 days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) were longer in the \u2265\u200980\u00a0cc group. Both cohorts demonstrated marked and durable improvement in urinary symptoms, with mean IPSS improving from 24.5 to 6.7 in the &lt;\u200980\u00a0cc group and from 24.9 to 6.0 in the \u2265\u200980\u00a0cc group at 24 months. Irritative symptom scores improved from 10.3 to 3.5 and from 10.5 to 2.1, respectively (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Sexual outcomes remained stable across prostate sizes, with preserved erectile function and low ejaculatory bother scores. High-grade complications (Clavien\u2013Dindo III\u2013IV) were uncommon and comparable between groups (2.7% vs. 4.3%), while reoperation rates remained low (3.1% vs. 3.9%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Aquablation provides durable symptom relief with preservation of sexual function across a broad range of prostate volumes, supporting its role as a size-independent surgical treatment option for BPH.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00345-026-06588-7","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T12:48:57Z","timestamp":1785415737000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The impact of prostate size on outcomes of aquablation: a prospective study"],"prefix":"10.1007","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4969-7019","authenticated-orcid":false,"given":"Dolev","family":"Perez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariel","family":"Mamber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Pasherstnik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dmitry","family":"Koulikov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ala Eddin","family":"Natsheh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ofer Z.","family":"Shenfeld","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilan Z.","family":"Kafka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boris","family":"Chertin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"issue":"Suppl 9","key":"6588_CR1","first-page":"S3","volume":"7","author":"CG Roehrborn","year":"2005","unstructured":"Roehrborn CG (2005) Benign prostatic hyperplasia: an overview. 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