Transurethral water vapour therapy (Rezūm) for catheter-dependent men secondary to benign prostatic hyperplasia: A retrospective study in a Hong Kong population

Abstract

Aim: Rezūm is a novel treatment for patients with moderate to severe lower urinary tract symptoms as a result of benign prostatic hyperplasia (BPH). Recently, it has expanded to patients with urinary retention causing catheter dependence and the results are promising in Whites. However, it is unclear how effective Rezūm is in the Chinese population. Here, we report our experience in performing Rezūm on catheter-dependent Chinese men with BPH and evaluate its safety and efficacy.

Methods: A retrospective review of catheter-dependent patients with BPH who underwent Rezūm from January to August 2022 was conducted. We evaluated the success rate of trial without catheter (TWOC) and compared pre- and post-operative (at 6 months) uroflowmetry results, International Prostate Symptoms Score (IPSS), IPSS Quality of Life Score (IPSS QoL), and prostate volume.

Results: Sixty-three patients had Rezūm performed (44 and 19 patients had refractory urinary retention and obstructive uropathy, respectively) with a mean age of 74 years and a mean prostate size of 53.9 mL. The first attempt at TWOC was successful in 53 patients (85.5%; range 15–44 days post-operation). By 98 days after the operation, all patients could void spontaneously. The 6-month follow-up showed that IPSS and IPSS QoL scores decreased by a mean of 9.0 and 1.8 points, respectively (both P < .01). The mean pre-operative post-voided residual urine was reduced by 559 mL (P < .01), with a mean prostate size reduction of 9.4 mL (P < .01). Seven patients had non-serious complications (Grade 1–2 Clavien–Dindo classification) within 30 days of operation.

Conclusion: Rezūm was shown to be effective and safe in catheter-dependent Chinese men with BPH.

Keywords

BPH-related catheter dependence / Rezūm / transurethral water vapour therapy

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