Water vapor therapy (Rezūm) for lower urinary tract symptoms related to benign prostatic hyperplasia: early results from the first Italian multicentric study

World J Urol. 2021 Oct;39(10):3875-3880. doi: 10.1007/s00345-021-03642-4. Epub 2021 Mar 31.

Abstract

Purpose: Rezūm is the latest developed minimally invasive treatment for benign prostatic hyperplasia (BPH). We aimed to carefully assess the functional outcomes of patients treated with Rezūm for BPH.

Methods: We prospectively followed 135 consecutive patients treated by Rezūm at 5 institutions from June 2019 to August 2020. The International Prostate Symptom Score (IPSS), International Consultation on Incontinence Questionnaire-Short Form (ICIQ-UI SF), the Overactive Bladder Questionnaire-Short Form (OAB-q SF) score, the International Index of Erectile Function (IIEF-5) and questions 9 and 10 to assess ejaculatory dysfunction were recorded. Election criteria were age > 18, no prior prostate interventions, IPSS ≥ 13, post-void residual ≤ 250 mL, prostate volume between 30 and 120 cc.

Results: The median operative time was 10.5 (IQR 8.7-15) min. All patients were dismissed few hours after surgery with indwelling urinary catheter that was removed after a median of 7 (IQR 7-10) days. A significantly decrease of IPSS from baseline at first (p = 0.001) and third (p < 0.0001) month after surgery was reported. No difference was reported in terms of ICIQ-UI SF score postoperatively. A mild reduction of the OAB-q SF score was reported at 1 month from surgery (p = 0.06) that turned significant at 3 months postoperatively (p < 0.0001). A slight but statistically significant increase of the IIEF-5 score was reported from baseline at 6 months (p = 0.04). Postoperatively, patients reported a significantly decrease of ejaculatory dysfunction after alpha-blocker interruption.

Conclusion: Rezūm treatment is a feasible minimally invasive option for patients with BPH symptoms and showed optimal early functional outcomes.

Keywords: Benign prostatic hyperplasia; Minimally invasive; Rezūm.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Follow-Up Studies
  • Humans
  • Hyperthermia, Induced / instrumentation*
  • Italy
  • Lower Urinary Tract Symptoms / etiology
  • Lower Urinary Tract Symptoms / therapy*
  • Male
  • Middle Aged
  • Prospective Studies
  • Prostatic Hyperplasia / complications*
  • Recovery of Function
  • Steam*
  • Surveys and Questionnaires
  • Treatment Outcome

Substances

  • Steam