Session: MP76: Benign Prostatic Hyperplasia: Surgical Therapy & New Technology IV
MP76-01: Mid-term Evaluation of Impact on Storage and Obstructive Symptoms with Rezūm: Outcomes of a Large, Multi-center, Prospective registry of Rezūm water vapor therapy benign prostatic enlargement
Introduction: Rezum convective water vapor ablation is a minimally invasive procedure to treat benign prostatic tissue. Herein, we report a prospective, multi-center results of the largest cohort of prostates treated with Rezum in Canada to address mid-term outcomes on IPSS storage and obstructive voiding symptoms. Methods: A prospective registry was established for Rezum therapy in Canada (2019) at two high-volume centers. All patients had baseline medical and BPH history documented along with uroflowmetry (Qmax and PVR), and validated questionnaires (IPSS, IPSS QoL, BPHII, IIEF-15, MSHQ-EjD function and bother). Sub-category IPSS-V and IPSS-S were evaluated for the entire cohort, men in retention and those with prostate volume>80cc vs <80cc and median lobe vs non-median lobe. IPSS-S was calculated by summing question 1 (incomplete emptying), question 3 (intermittency), question 5 (weak stream), and question 6 (straining to void). IPSS-V was calculated by summing question 2 (frequency), question 4 (urgency), and question 7 (nocturia). Results: 345 men (mean age of 67.4, were treated with Rezum from April 2019 to October 2022. The mean prostate volume was 72.3cc (range 17-271) and 64% had a median lobe. 85 patients had prior episode of urinary. Mean number of injections was 10.1(range 2-28). Mean duration of procedure was 3.7 minutes (range 1-13). Mean duration of post-procedure catheterization was 9.8 days. IPSS-S reduced from a baseline score of 9.4 to 8.4 (10%), 6.1 (35%), 4.9 (48%), 4.8 (49%), 4.6 (51%), 4.3 (54%) at 1,3,6, 12,24 and 36 months respectively. Comparatively, IPSS-V reduced from a baseline of 12.7 to 7.7 (39%), 4.1 (67%), 4.3 (66%), 4.3 (66%), 4.6 (64%), 3.7 (70%) at 1,3,6,12,24 and 35 months respectively. Outcomes were similar among subgroup analysis of men with baseline retention, men with prostate volume >80cc or those with median lobe (all p>0.05). Conclusions: Rezum therapy is safe, effective, quick, out-patient, office-based procedure for prostate glands over a wide range of volumes with equally significant improvements in storage and voiding symptoms regardless of prostate volume, median lobe status and baseline urinary retention. SOURCE OF Funding: No
