Introduction: Rezum water vapour therapy is a minimally invasive surgical technique for treatment of benign prostatic hyperplasia (BPH). Antiplatelets or anticoagulation medications (APAC) are usually suspended prior to Rezum to reduce the risk of bleeding. Continuation of APAC reduces the risk of cardiovascular events for patients with advanced age and multiple comorbidities. This study aims to report the outcomes of Rezum in patients who are continued on antiplatelet or anticoagulation medication. Methods: All patients on antiplatelet or anticoagulation medication who had undergone Rezum from November 2021 to August 2022 at a single centre in Singapore were followed up for 3 months. APAC were continued perioperatively. Outcomes were measured at 1 month, 2 month and 3 months postoperatively. Results: N=15 men underwent Rezum while on APAC. 13 patients (87%) were on single antiplatelet therapy, 1 patient (7%) on novel anticoagulation therapy (NOAC): apixaban, and 1 patient (7%) on both NOAC and antiplatelet therapy: apixaban and clopidogrel. There was a sustained improvement in Qmax. 13 out of 15 patients (87%) had a successful removal of catheter. No complications of Clavien-Dindo classification greater than two at 30 days were observed. 2 patients (13%) required a manual bladder washout postoperatively. 1 patient (7%) was readmitted for a urinary tract infection and orchitis. 1 patient (7%) had a bladder neck contracture, who required an elective transurethral bladder neck incision after 2 months. Conclusions: This pilot study suggests that Rezum is a safe and effective option for patients who have bothersome lower urinary tract symptoms, and cannot stop anticoagulation or antiplatelet medication. SOURCE OF Funding: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
