To investigate safety and feasibility of performing water vapor thermal therapy (WVTT; Rezum, Boston Scientific, Marlborough, MA, USA) without postoperative catheterization among men with benign prostatic hyperplasia.
This is a prospective, single arm, unblinded pilot study of 20 consecutive male patients ages 40-80 who underwent WVTT at a single academic institution. All patients underwent 1 injection per lobe at the point of maximal obstruction based on visualization. Primary outcome was evaluation of voiding parameters, symptom scores, and need for catheterization at 3 day, 1, 3, and 6 month follow up compared to baseline visit 30 days prior to surgery.
Mean age was 65 years (range 55-75). Mean prostate volume and PVR were 43 cc (range 30-68) and 89 cc, with 30% (n = 6) having median lobes. Patients received 2-3 treatments based on presence of bilobar versus trilobar hyperplasia. One patient (55 cc prostate, no median lobe) required catheterization for acute urinary retention on postoperative day 2. No patients required antibiotics for urinary tract infection or inpatient readmission within 30 days. Qmax significantly increased from 6 mL/s to 8, 13, 12, and 14 at 3 days, 1, 3, and 6 months (p < 0.05). IPSS decreased from 17 preoperatively to 10, 6, 7, and 8 (p < 0.05). No significant differences were noted in PVR, IIEF, MSHQ-EjD, or SF-12.
In well-selected men, catheter-free WVTT is feasible and improved voiding parameters and symptom scores. No changes in sexual function, infectious complications, or readmission were noted. Only 1 patient (5%) required postoperative catheterization within 30 days.
World journal of urology. 2024 Jun 21*** epublish ***
Vi Nguyen, Joshua Winograd, Alia J Codelia-Anjum, Kevin C Zorn, Dean Elterman, Naeem Bhojani, Seth K Bechis, Bilal Chughtai
Department of Urology, University of California, 9333 Genesee Avenue, Suite 320, La Jolla, CA, 92121, USA. ., Department of Urology, Weill Cornell Medical College/New York Presbyterian, New York, NY, USA., Department of Urology, University of Montreal Hospital Center, Montreal, QC, Canada., Division of Urology, Department of Surgery, University Health Network, University of Toronto, Toronto, ON, Canada., Department of Urology, University of California, 9333 Genesee Avenue, Suite 320, La Jolla, CA, 92121, USA., Department of Urology, New Hyde Park, Northwell Health, NY, USA.
PubMed http://www.ncbi.nlm.nih.gov/pubmed/38904777