Two-year follow-up comparing Rezūm therapy versus bipolar transurethral resection of the prostate for treating benign prostatic hyperplasia. A prospective randomized study

Int J Urol. 2024 May;31(5):545-550. doi: 10.1111/iju.15410. Epub 2024 Jan 30.

Abstract

Objective: Comparison of the efficacy and safety of Rezūm therapy and bipolar transurethral resection of prostate (B-TURP) for the management of benign prostatic hyperplasia (BPH) of 50-120 g size.

Methods: One hundred patients with BPH who met the inclusion criteria were included and split into two equal groups to undergo Rezūm therapy or B-TURP. The two groups were compared for efficacy using international prostate symptom score (IPSS), quality of life (QoL), maximum urinary flow rate (Qmax), operative time, catheter time, hospital stay, post-void residual urine (PVR), prostate-specific antigen (PSA), and residual prostate size and safety using the incidence of complications.

Results: Rezūm significantly ameliorated IPSS from the baseline score by 55.3%, QoL by 50%, Qmax by 62.5%, International Index of Erectile Function (IIEF) by 7.1%, PVR by 50%, residual prostate size by 28.1% and PSA by 42% at 2 years. Meanwhile, the improvement in B-TURP was significantly higher than Rezūm group, Rezūm therapy had a significantly shorter duration of operative time and hospital stay. Also, it had fewer complications in comparison with B-TURP.

Conclusions: Rezūm is a minimally invasive procedure that provides significantly improved symptomatic relief of BPH and quality of life with preservation of erectile and ejaculatory functions. However, it is not as effective as B-TURP.

Keywords: BPH; B‐TURP; LUTS; Rezūm; thermal therapy.

Publication types

  • Randomized Controlled Trial
  • Comparative Study

MeSH terms

  • Aged
  • Bacterial Toxins*
  • Follow-Up Studies
  • Humans
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Operative Time
  • Pore Forming Cytotoxic Proteins*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Prospective Studies
  • Prostate / pathology
  • Prostate / surgery
  • Prostate-Specific Antigen / blood
  • Prostatic Hyperplasia* / surgery
  • Quality of Life*
  • Transurethral Resection of Prostate* / adverse effects
  • Transurethral Resection of Prostate* / methods
  • Treatment Outcome

Substances

  • Prostate-Specific Antigen
  • PRX302
  • Bacterial Toxins
  • Pore Forming Cytotoxic Proteins