Treatment of benign prostate hyperplasia using the Rezum® water vapor therapy system: Results at one year

Prog Urol. 2020 Oct;30(12):624-631. doi: 10.1016/j.purol.2020.05.004. Epub 2020 Aug 18.

Abstract

Purpose: To report the results of convective radiofrequency (RF) water vapor thermal therapy in men with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) with one-year follow-up evaluation.

Material and method: The study was conducted in 2 French hospitals, for men with moderate to severe LUTS secondary to BPH, as an alternative to classical surgery treatment. The pre- and postoperative evaluation of urinary symptomatology was based on the International Prostate Symptom Score (IPSS) questionnaire, measures of peak urinary flow rate (Qmax) and post-void residual volume (PVR). Erectile and ejaculatory functions were evaluated via the IIEF5 and MSHQ-ejd questionnaires. Rates of retreatment and complications were also reported.

Results: Sixty-two outpatients including 8 with urinary retention were treated. The median preoperative prostate volume was 47 (27-200) mL. At 6months postoperative, the IPSS had decreased significantly by 13.9 points (68.1%, P<0.001) and, at one year, by 12 points (61.5%, P<0.001). The quality of life (QoL) score at one year had decreased by 3.2 points (P<0.001) and the Qmax had improved by 6mL/s (P<0.001). All patients with urinary retention were weaned from bladder catheterization. No serious side effects (>Clavien II) were observed. No cases of de novo erectile dysfunction and an anejaculation rate of 10.8% was reported. The surgical retreatment rate at one year was 2.1%.

Conclusion: The short-term results are encouraging, with significant efficacy on urinary symptoms and respect of sexual function. Nevertheless, it will be necessary to pursue the follow-up of this cohort to evaluate the mid-term and long-term evolution.

Level of evidence: 3.

Keywords: Benign prostate hyperplasia; Hyperplasie bénigne de prostate; Lower urinary tract symptoms; Prostate; Rezum®; Symptômes du bas appareil urinaire; Thermotherapy; Thermothérapie.

MeSH terms

  • Humans
  • Hyperplasia
  • Lower Urinary Tract Symptoms* / etiology
  • Male
  • Prostate
  • Prostatic Hyperplasia* / complications
  • Prostatic Hyperplasia* / surgery
  • Quality of Life
  • Steam
  • Treatment Outcome

Substances

  • Steam