EAU 2018: A Real World Single Office Experience With The Rezum Radio Frequency Water Vapor Thermal Therapy System For Benign Prostatic Hyperplasia
Dr. Mollengarden (MD) of UT Southwestern Medical Center Department of Urology in Dallas, Texas of the United States presents a retrospective review of 129 patients undergoing the Rezum by a single surgeon. Patient outcome data, including prostate volume and patient satisfaction with the procedure were collected cross-sectionally at four months post-procedure.
Of the 129 patients included in the study, it is notable that the first 25 patients included in the analysis also underwent BPH medication washouts prior to the procedure. Outcomes of IPSS scores, maximum flow rates, residual urine volume, medication usage, and adverse events were monitored.
The mean age of the patient cohort was 67.4 of patients, with an average pre-procedure IPSS of 18.3. 10.4%, 44.8%, and 44.8% of patients had IPSS scores within the mild, moderated, and severe ranges, respectively.
After Rezum procedures, the mean IPSS improved by 11.4 units (18.3 pre-procedure vs. 6.9 post-procedure). Along similar lines, the Qmax improved 6.3 ml/sec (10.5 pre-procedure vs. 16.8 post-procedure). Multivariate analysis revealed that these improvements remained statistically significant after controlling for covariates such as starting symptom score, treatment at the median lobe, and prostate size (categorical).
Of note, the most common adverse events were urinary tract symptoms in 22 patients’ and transient urinary retention in 18 patients. Despite these side effects / complications, 90% of patients stopped utilizing any BPH medications and a large majority of patients would recommend the procedure. As such, Rezum radiofreqency thermal therapy has been regarded as a worthy alternative to the TURP for treatment of BPH. The authors note that the benefits are independent of prostate size or the presence of the median lobe, of which there are moderate improvements in both the IPSS and peak flow rates. In conjunction with the results of the WATER study out of the same institution, Rezum and aquablation represent a new frontier of minimally invasive techniques for the treatment of BPH-related LUTS.
Authors: Mollengarden D., Goldberg K., Wong D., Roehrborn C
Written by: Linda M. Huynh, B.S., University of California-Irvine, at the 2018 European Association of Urology Meeting EAU18, 16-20 March, 2018 Copenhagen, Denmark