Introduction To compare the clinical outcomes and complication rates of Convective Water Vapour Energy Ablation (Rezum®) and Prostatic Urethral Lift (Urolift®). To identify predictive factors for treatment failures in both treatments. Materials & Methods Prospective clinico-epidemiological data of patients who underwent Urolift® or Rezum® in a single institution for Benign Prostatic Hyperplasia (BPH) was collected. The choice of intervention depended on the preference of the patients after patient-centric discussions. Results From October 2019 to October 2022, 86 patients underwent Rezum® and 62 patients underwent Urolift®. Rezum® involved a longer indwelling catheter duration (12.38±5.548 versus 1.39±3.010 days, p<0.001) compared to Urolift®. Rezum® was associated with more complications compared to Urolift® (36 (41.9%) versus 10 (16.1%) cases, p<0.001). Rezum® had more cases of hematuria (17 (19.8%) versus 4 (6.5%) cases (p=0.022)) and urinary tract infections (27 (31.4%) versus 3 (4.8%) cases, p<0.001)), compared to Urolift®. There were no significant differences in Clavien-Dindo Grade 3-5 complications between the interventions. Urolift® was associated with higher re-operation rates (5 (8.1%) versus 0 (0%) cases, p=0.010) compared Rezum®. Rezum® had higher anti-cholinergic usage rates compared to Urolift® post-operation (22 (25.6%) versus 8 (12.9%) cases, p=0.024). Both interventions showed improvement in International Prostate Symptom Score (IPSS), Quality of Life score, and peak velocity flow over the 2 years with no significant difference between the two. Based on receiver operating characteristic curve, pre-operation IPSS ≥ 16 had 95.7% sensitivity and 38.4% specificity to predict the probability of treatment failures after the interventions. Conclusions There was no difference in clinical outcomes of patients who underwent Rezum® and Urolift®. However, patients who had undergone Rezum® faced more minor complications and more required anti-cholinergic medications. Lastly, physicians should note that patients with IPSS≥16 would unlikely benefit from either intervention.
Journal of endourology. 2024 Sep 20 [Epub ahead of print]
Yu Xi Terence Law, Wei Jing Kelven Chen, Liang Shen, Kyaw Lin, Chloe Shu Hui Ong, Qi Yang Lim, Gregory Xiang Wen Pek, Woon Chau Tsang, Yi Quan Tan, Jun Yang Chia, King Chien Joe Lee, Wei Jin Chua
National University Hospital, Urology, Singapore, Singapore, Singapore; ., National University Hospital, Urology, Singapore, Singapore, Singapore; ., National University of Singapore Yong Loo Lin School of Medicine, Biostatistics Unit, Singapore, Singapore; ., National University Hospital, Urology, Singapore, Singapore, Singapore; ., National University Hospital, Urology, Singapore, Singapore, Singapore; ., National University Hospital, Urology, Singapore, Singapore, Singapore; ., National University Hospital, Urology, Singapore, Singapore, Singapore; ., National University Hospital, Urology, Singapore, Singapore, Singapore; ., National University Hospital, Urology, Singapore, Singapore, Singapore., National University Hospital, Urology, Singapore, Singapore, Singapore; ., National University Hospital, Urology, Singapore, Singapore, Singapore; .