{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T15:40:53Z","timestamp":1781192453205,"version":"3.54.1"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Urology"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To identify optimal candidates for Aquablation during the initial adoption phase by determining predictors of operative time and bladder irrigation volume to guide safe implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 123 patients who underwent Aquablation between 2023 and 2025 during the initial implementation of this technique by Aquablation\u2010na\u00efve urologists at our institution. Patients with short operative times and low irrigation volumes were considered optimal candidates. Preoperative variables were assessed using multivariable linear regression. Because prostate volume (PV) demonstrated the strongest association with operative time and irrigation volume, post hoc exploratory locally estimated scatterplot smoothing (LOESS) analysis was performed to define a data\u2010driven PV threshold, and perioperative outcomes were compared above and below this threshold.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      PV (median, 78\u2009mL; interquartile range, 60\u2013100\u2009mL) was the only independent predictor of long operative times and great irrigation volumes. LOESS identified a PV threshold near 80\u2009mL for bladder irrigation volume and 100\u2009mL for operative time. Patients with PV &lt;\u2009100\u2009mL had more favorable perioperative outcomes. Compared with PV \u2265\u2009100\u2009mL, PV &lt;\u2009100\u2009mL had shorter operative times (median, 56 vs. 81\u2009min;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05), lower irrigation volumes (median 9000 vs. 14\u2009000\u2009mL;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05), and smaller hemoglobin reductions (\u22120.9 vs. \u22121.6\u2009mg\/dL;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05); rates of Clavien\u2010Dindo \u2265\u20093 adverse events, transfusion, and refulguration did not differ.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A PV &lt;\u2009100\u2009mL appears to be a practical criterion for safe early adoption of Aquablation; accurate preoperative estimation of PV is therefore essential.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/iju.70373","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T12:12:57Z","timestamp":1770034377000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Optimizing Patient Selection for Aquablation During the Initial Adoption Phase: Prostates Smaller Than 100\u2009\n                    <scp>mL<\/scp>"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1428-9736","authenticated-orcid":false,"given":"Shin","family":"Koike","sequence":"first","affiliation":[{"name":"Department of Urology Itabashi Chuo Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1633-784X","authenticated-orcid":false,"given":"Yu","family":"Ozawa","sequence":"additional","affiliation":[{"name":"Department of Urology Itabashi Chuo Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kei","family":"Ushijima","sequence":"additional","affiliation":[{"name":"Department of Urology Itabashi Chuo Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keita","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Department of Urology Itabashi Chuo Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiaki","family":"Kayaba","sequence":"additional","affiliation":[{"name":"Department of Urology Itabashi Chuo Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2827-0527","authenticated-orcid":false,"given":"Sunao","family":"Nohara","sequence":"additional","affiliation":[{"name":"Department of Urology Itabashi Chuo Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masumi","family":"Yamada","sequence":"additional","affiliation":[{"name":"Department of Urology Itabashi Chuo Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keisuke","family":"Aoki","sequence":"additional","affiliation":[{"name":"Department of Urology Itabashi Chuo Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Odagaki","sequence":"additional","affiliation":[{"name":"Department of Urology Itabashi Chuo Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideo","family":"Sakamoto","sequence":"additional","affiliation":[{"name":"Department of Urology Itabashi Chuo Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunihiko","family":"Yoshioka","sequence":"additional","affiliation":[{"name":"Department of Urology Itabashi Chuo 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