https://doi.org/10.4081/aiua.2023.12026

Evaluation of Rezum therapy as a minimally invasive modality for management of Benign Prostatic Hyperplasia: A prospective observational study

Vol. 95 No. 4 (2023)
Submitted: October 24, 2023
Accepted: November 13, 2023
Published: December 28, 2023
Hyperplasia, Prostate, Rezum
Abstract Views: 825
PDF: 402
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Tamer A. Abouelgreed
dr_tamer_ali@yahoo.com
https://orcid.org/0000-0003-2640-3425
Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt; Gulf Medical University, Ajman, United Arab Emirates.
Ayman K. Koritenah
Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Yasser Badran
Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Ibrahim Tagreda
Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Mohamed Algammal
https://orcid.org/0009-0002-0472-4914
Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Hesham Abozied
https://orcid.org/0000-0001-8373-930X
Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Hany A. Eldamanhory
Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Hossam A. Shouman
Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Abdelhamid A. Khattab
Department of Urology, Damanhur Teaching Hospital, Albuheira Government, Egypt.
Munira Ali
Department of Radiology, Thumbay University Hospital, Ajman, United Arab Emirates.
Mohammad Thabet Alnajem
Department of Radiology, Tawam Hospital, Alain, United Arab Emirates.
Ahmed A. Abdelwahed 
https://orcid.org/0000-0003-4224-1622
Department of Radiology, Ain shams University, Cairo, Egypt.

Objective: To evaluate safety and efficacy of Rezum therapy as a minimally invasive modality for management of benign prostatic hyperplasia in patients with prostate volume < 80cc and those with prostate volume > 80cc. Methods: Between June 2020 and February 2023, A total of 98 patients diagnosed with BPH and managed by Rezum were included in this study. Patients were divided based on their prostate volume of either less than 80 cc or greater than 80 cc. We evaluated several parameters related to their condition, including prostate volume, post-voiding residual (PVR) before and after surgery, number of treatments received, maximum urine flow rate (Qmax) before and after surgery and mean follow- up periods. Results: The mean age was 68 years (SD 11.2). The median prostatic volume was 62 cc (IQR 41, 17). A maximum of 9 treatments were administered. Six months was determined to be the average post-operative follow-up period (IQR: 3.5-7.2). The mean preoperative total PSA was 2.7 (IQR 1, 2), preoperative mean PVR was 79.8 cm3, preoperative mean Qmax was 8.2 ml/s (IQR 4.7-10.5), and median post-operative days until catheter removal was four days (IQR 3,1). Post-operative PVR was 24.7 cm3 (IQR 18.2, 29.4) and the mean post-operative Qmax was 18.3 ml/s (SD 6.3). Qmax levels significantly increased, by an average of 8.2 ml/s (SD 7.13) (p < 0.001). Similarly, a decrease of average PVR of 97.28 cm3 (SD 95.85) (p < 0.001) was detected, which is a substantial reduction. Between prostates less 80cc and those over 80cc, there were no appreciable differences in Qmax or PVR (p-values: 0.435 and 0.431, respectively). Conclusions: From our study, we conclude that Rezum water vapor thermal therapy, as a minimally invasive modality, is an effective and safe surgical option for management of benign prostatic hyperplasia of men with moderate to severe lower urinary tract symptoms (LUTS). This procedure has been shown to be effective in patients with varying larger prostate volumes.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
Speakman M, Kirby R, Doyle S, Ioannou C. Burden of male lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) - focus on the UK. BJU Int. 2015; 115:508-519. DOI: https://doi.org/10.1111/bju.12745
Lee SWH, Chan EMC, Lai YK. The global burden of lower urinary tract symptoms suggestive of benign prostatic hyperplasia: a systematic review and meta-analysis. Sci Rep. 2017; 7:7984. DOI: https://doi.org/10.1038/s41598-017-06628-8
Foster HE, Dahm P, Kohler TS, et al. Surgical management of lower urinary tract symptoms attributed to benign prostatic hyperplasia: AUA Guideline Amendment 2019. J Urol. 2019; 202:592-8. DOI: https://doi.org/10.1097/JU.0000000000000319
Guo RQ, Yu W, Meng YS, et al. Correlation of benign prostatic obstruction-related complications with clinical outcomes in patients after transurethral resection of the prostate. Kaohsiung J Med Sci. 2017; 33:144-51. DOI: https://doi.org/10.1016/j.kjms.2017.01.002
Jones P, Rai BP, Nair R, Somani BK. Current status of prostate artery embolization for lower urinary tract symptoms: review of world literature. Urology. 2015; 86:676-81. DOI: https://doi.org/10.1016/j.urology.2015.05.011
Jones P, Rajkumar GN, Rai BP, et al. Medium-term outcomes of urolift (minimum 12 months follow-up): evidence from a systematic review. Urology. 2016; 97:20-4. DOI: https://doi.org/10.1016/j.urology.2016.05.003
Green Z, Westwood J, Somani BK. What's new in rezum: a transurethral water vapour therapy for BPH. Curr Urol Rep. 2019; DOI: https://doi.org/10.1007/s11934-019-0903-7
:39.
Mynderse LA, Hanson D, Robb RA, et al. Rezum System Water Vapor Treatment for Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia: Validation of Convective Thermal Energy Transfer and Characterization with Magnetic Resonance Imaging and 3-Dimensional Renderings. Urology. 2015; 86:122-7. DOI: https://doi.org/10.1016/j.urology.2015.03.021
Dixon CM, Cedano ER, Pacik D, et al. Two-year results after convective radiofrequency water vapor thermal therapy of symptomatic
benign prostatic hyperplasia. Res Rep Urol. 2016; 8:207-16.
McVary KT, Rogers T, Roehrborn CG: Rezum water vapor thermal therapy for lower urinary tract symptoms associated with benign prostatic hyperplasia: 4-year results from randomized controlled study. Urology. 2019; 126:171-9. DOI: https://doi.org/10.1016/j.urology.2018.12.041
Gupta N, Rogers T, Holland B, et al. Three-year treatment outcomes of water vapor thermal therapy compared to doxazosin, finasteride and combination drug therapy in men with benign prostatic hyperplasia: cohort data from the MTOPS trial. J Urol. 2018; 200:405-13. DOI: https://doi.org/10.1016/j.juro.2018.02.3088
Aboutaleb H, Ali TA, Zaghloul A, Amin MM. Efficacy of bipolar ‘button’ plasma vaporisation of the prostate compared to green laser vaporisation for benign prostatic obstruction. Journal of Clinical Urology. 2018; 11: 350-356. DOI: https://doi.org/10.1177/2051415817752855
Arezki A, Sadri I, Couture F, et al.: Reasons to go for Rezum steam therapy: an effective and durable outpatient minimally invasive procedure. World J Urol. 2021; 39:2307-13. DOI: https://doi.org/10.1007/s00345-020-03457-9
Ulchaker JC, Martinson MS. Cost-effectiveness analysis of six therapies for the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia. Clinicoecon Outcomes Res. 2018; 10:29-43. DOI: https://doi.org/10.2147/CEOR.S148195
Darson MF, Alexander EE, Schiffman ZJ, et al. Procedural techniques and multicenter postmarket experience using minimally invasive
convective radiofrequency thermal therapy with Rezum system for treatment of lower urinary tract symptoms due to benign prostatic hyperplasia. Res Rep Urol. 2017; 9:159-68. DOI: https://doi.org/10.2147/RRU.S143679
Johnston M, Shah T, Emara A, et al. Rezum water vapour ablation therapy for benign prostatic hyperplasia: Preoperative results from the United Kingdom. J Urol. 2019; 201: e1-e2. DOI: https://doi.org/10.1097/01.JU.0000554867.66478.23
Johnston MJ, Noureldin M, Abdelmotagly Y, et al. Rezum water vapour therapy: promising early outcomes from the first UK series. BJU Int. 2020; 126:557-8. 10.1111/bju.15203. DOI: https://doi.org/10.1111/bju.15203
Mollengarden D, Goldberg K, Wong D, Roehrborn C. Convective radiofrequency water vapor thermal therapy for benign prostatic hyperplasia: a single office experience. Prostate Cancer Prostatic Dis. 2018; 21:379-85. DOI: https://doi.org/10.1038/s41391-017-0022-9
Garden EB, Shukla D, Ravivarapu KT, et al. Rezum therapy for patients with large prostates (≥ 80 g): Preoperative clinical experience and postoperative outcomes. World J Urol. 2021; 39:3041-8. DOI: https://doi.org/10.1007/s00345-020-03548-7
Cindolo L, Pirozzi L, Fanizza C, et al. Drug adherence and clinical outcomes for patients under pharmacological therapy for lower urinary tract symptoms related to benign prostatic hyperplasia: population-based cohort study. Eur Urol. 2015; 68:418-25. DOI: https://doi.org/10.1016/j.eururo.2014.11.006
McVary KT, Holland B, Beahrs JR. Water vapor thermal therapy to alleviate catheter-dependent urinary retention secondary to benign prostatic hyperplasia. Prostate Cancer Prostatic Dis. 2020; 23:303-308. DOI: https://doi.org/10.1038/s41391-019-0187-5
Hossam A. Shouman, Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo

 

 

Abdelhamid A. Khattab, Department of Urology, Damanhur Teaching Hospital, Albuheira Government

            

 

Ahmed A. Abdelwahed , Department of Radiology, Ain shams University, Cairo

    

Affiliation: Department of Radiology, Ain shams University, Cairo, Egypt                                               Email:

How to Cite

Abouelgreed, T. A., Koritenah, A. K., Badran, Y., Tagreda, I., Algammal, M., Abozied, H., Eldamanhory, H. A., Shouman, H. A., Khattab, A. A., Ali, M., Alnajem, M. T., & Abdelwahed , A. A. (2023). Evaluation of Rezum therapy as a minimally invasive modality for management of Benign Prostatic Hyperplasia: A prospective observational study. Archivio Italiano Di Urologia E Andrologia, 95(4). https://doi.org/10.4081/aiua.2023.12026
Copyright (c) 2023 the Author(s) Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.