Rezŭm water vaporization therapy versus transurethral resection of the prostate in the management of refractory urine retention: matched pair comparative multicenter experience

Waseem Tayeb; Raed A Azhar; Mohnna Subahi; Sameer Munshi; Abdulrahman Qarni; Abdulaziz Bakhsh; Majid Sejiny; Turkey Almohaisen; Adel Alammari; Mohamed A Elkoushy

doi:10.1007/s00345-023-04739-8

Rezŭm water vaporization therapy versus transurethral resection of the prostate in the management of refractory urine retention: matched pair comparative multicenter experience

World J Urol. 2024 Jan 20;42(1):48. doi: 10.1007/s00345-023-04739-8.

Authors

Affiliations

¹ Department of Surgery, Division of Urology, King Abdullah Medical City at Holy Capital, Makkah, Saudi Arabia. waseemtayeb@yahoo.com.
² Faculty of Medicine, Urology Department, King Abdulaziz University, Jeddah, Saudi Arabia.
³ Department of Surgery, Division of Urology, King Abdullah Medical City at Holy Capital, Makkah, Saudi Arabia.
⁴ Urology Department, Dr Soliman Fakeeh Hospital, Jeddah, Saudi Arabia.
⁵ Urology Department, College of Medicine, Taibah University, Madinah, Saudi Arabia.
⁶ Urology Department, College of Medicine, University of Jeddah, Jeddah, Saudi Arabia.
⁷ Urology Department, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.
⁸ Faulty of Medicine, Urology Department, Suez Canal University, Ismailia, Egypt.

^# Contributed equally.

PMID: 38244100
DOI: 10.1007/s00345-023-04739-8

Abstract

Purpose: To compare the efficacy of Rezūm with a matched cohort of patients undergoing transurethral resection of the prostate (TURP) for catheter-dependent urine retention secondary to benign prostate hyperplasia (BPH).

Methods: A retrospective review was performed for consecutive catheter-dependent patients who underwent Rezūm for BPH. Patients were matched and compared with a similar cohort undergoing TURP, using non-inferiority analysis on propensity score-matched patient pairs. Patients were followed up at 1, 3, 6 and 12 months by international prostate symptoms score (IPSS), quality of life (QoL) index, peak flow rate (Qmax) and postvoid residual urine (PVR).

Results: Eighty-one patients undergoing Rezūm were compared with equal number of matched patients who undergoing TURP. Patients undergoing Rezūm experienced significantly shorter operation time (25.5 ± 8.7 vs. 103.4 ± 12.6 min; p < 0.001), lower intraoperative bleeding (2.4% vs. 20.7%, p < 0.001), shorter hospital stay (1.2 ± 0.9 vs. 2.4 ± 1.3 d, p < 0.001) and longer catheter time (12.6 ± 6.0 vs. 2.3 ± 1.2 d, p < 0.001), with no need for transfusion. Successful postoperative voiding was comparable between both arms (90.2% vs. 92.7%, p = 0.78), respectively. Despite patients undergoing TURP had significantly better voiding outcomes after 1 and 3 months, both groups were comparable after six and 12 months in terms of mean IPSS (11.1 ± 6.4 vs. 10.8 ± 3.4, p = 0.71), QoL indices (2.4 ± 1.6 vs. 2.1 ± 2.3, p = 0.33) and Qmax (22.0 ± 7.7 v. 19.8 ± 6.9 ml/sec, p = 0.06).

Conclusion: This study supports the safety and efficacy of Rezūm in the management of catheter-dependent patients secondary to BPH, with comparable functional outcomes to TURP. Until a randomized clinical comparison is available, long-term data are crucially recommended to compare the recurrence and reoperation rates.

Keywords: Outcomes; Prostate; Rezūm; Transurethral resection; Urine retention.

Publication types

Multicenter Study

MeSH terms

Humans
Male
Prostate / surgery
Prostatic Hyperplasia* / complications
Prostatic Hyperplasia* / surgery
Quality of Life
Transurethral Resection of Prostate*
Treatment Outcome
Urinary Retention* / etiology
Urinary Retention* / surgery
Volatilization
Water

Substances

Water