Rezūm water vapor thermal therapy for large-volume, symptomatic benign prostatic enlargement
Large, multicenter, real-world cohort with two-year followup
DOI:
https://doi.org/10.5489/cuaj.9336Keywords:
Rezūm Water Vapor Thermal Therapy, Minimally invasive surgical therapies, benign prostate obstructionAbstract
INTRODUCTION: Water vapor thermal therapy (WVTT), Rezūm, is a minimally invasive therapy that uses water vapor to ablate benign prostatic tissue. This study aimed to present the prospective, multicenter outcomes of the largest cohort of prostates ≥80 mL treated with Rezūm.
METHODS: This study involved a prospective, WVTT registry that collated information from two high-volume centers between April 2019 and August 2024. Baseline medical histories, uroflowmetry (peak flow rate [Qmax], postvoid residual [PVR]), and validated questionnaires (International Prostate Symptom Score [IPSS], IPSS quality of life (QoL), Benign Prostatic Hyperplasia Impact Index [BPHII], International Index of Erectile Function [IIEF-15], Male Sexual Health Questionnaire for Ejaculatory Dysfunction [MSHQ-EjD]) were recorded. The main outcomes assessed included symptom scores, functional improvement, and safety at baseline, six, 12, and 24 months.
RESULTS: A total of 259 patients with a prostate volume ≥80 mL were treated with Rezūm. The median prostate volume was 105 mL, with 207 patients (81.2%) exhibiting a median lobe. The IPSS improved from 21.8 at baseline to 5.7 at 24 months. The IPSS QoL score improved from 4.5 at baseline to 1.1 at 24 months. At baseline, the Qmax rate was 8.2 mL/s, increasing to 14.9 mL/s at 24 months. PVR volume decreased from 132.5 mL at baseline to 90 mL at 24 months. The BPHII decreased from 7.5 at baseline to 2.3 at 24 months. There was no significant change in sexual function as measured by IIEF and MSHQ.
CONCLUSIONS: Rezūm therapy is a safe, effective, and minimally invasive option for managing large prostates (≥80 mL), providing significant and sustained improvements in urinary symptoms with minimal impact on sexual function.
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