Assessing water vapor therapy for lower urinary tract symptoms from benign prostatic hyperplasia

This study investigated the use of water vapor thermal therapy using the Rezum system as a minimally invasive treatment option for benign prostatic hyperplasia (BPH). The authors concluded that Rezum is a good minimally invasive treatment option that showed promising results for patients with BPH.

BPH is a commonly occurring, progressive condition, particularly in older men. The condition causes lower urinary tract symptoms (LUTS) such as difficulties in initiating urination, urine retention and a need to urinate multiple times during the night. This is commonly due to an increase in prostate size. Several management options exist for BPH. Medications and prostate surgery are amongst the most common treatments. However, minimally invasive surgical techniques are being investigated.

Rezum water vapor thermal therapy represents one of the latest developments in minimally invasive options. This form of water vapor is produced by thermal energy using radiofrequency. Steam is used to vaporize extra prostate tissue blocking urine flow. The technique can be quickly performed under local anesthesia. A 40% prostate tissue shrinkage is expected within 3 months of the procedure. Improvements in the quality of life and preservation of sexual function are also expected. It is important to evaluate the functional outcomes of patients treated with this procedure.

135 patients with moderate-to-severe LUTS from BPH were included in the study. All patients had prostate volumes between 30 and 120 cc. Patients were treated by intraprostatic water vapor injections using the Rezum system and were followed up at 1, 3, and 6 months.

The average time of the procedure was 10.5 minutes. On average, urinary catheter removal was done after 7 days. Overall, patients had a 48% complication rate. All the side effects were mild and included bloody urine and sperm, pain while urinating, and urinary infections. 

Patients reported significant improvements in LUTS at all time points after surgery. A significant improvement in sexual function and satisfaction was seen at 6 months after the procedure.

The study indicated that the Rezum system has the potential for good treatment results for BPH based on early follow-up data.

The study did not include a control group. Further studies are needed with long-term follow-up.