Comparing the effectiveness of convective water vapor energy therapy with prostatic urethral lift for benign prostatic hyperplasia

This study reviewed and compared the effectiveness of convective water vapor energy therapy (WAVE) with prostatic urethral lift (PUL) in men with benign prostatic hyperplasia (BPH). The data showed that WAVE treatment improved the urinary flow rate and durability of response compared to PUL treatment.

BPH is a non-cancerous enlargement of the prostate gland. These patients often experience lower urinary tract symptoms (LUTS). These include symptoms such as difficulties emptying the bladder, urine leakage, or getting up to urinate during the night. These can be treated using medications. However, these medications can be associated with loss of sexual function.

Another option for these patients is a minimally invasive treatment (MIT) procedure which is associated with preserving sexual function. PUL is a MIT procedure associated with improved outcomes and fewer side effects. It involves using implants in the prostate that retract the enlarged prostate lobes to allow more space for the urethra. This allows the urine to flow more freely.

Another option is convective WAVE treatment. WAVE is also a MIT procedure consisting of delivering thermal energy in the form of steam to the prostate tissue blocking urine flow. This will remove excess prostatic tissue improving the urinary symptoms. The effectiveness of PUL compared to WAVE in men with BPH is not known.

This study analyzed the results of 2 trials involving 403 patients with BPH. Patients were treated with either PUL, WAVE, or a placebo procedure. Urinary symptoms and quality of life (QoL) of patients were measured. The average follow-up period was 60 months.

Both treatments showed improvements in urinary symptoms compared to the placebo procedures. However, WAVE treatment provided a greater increase in the flow of urine compared to PUL treatment. Other symptom improvements were similar between the PUL and WAVE procedures. The proportion of patients that did not need other BPH treatments after 4 years was 89.1% for WAVE versus 75.4% for PUL treatment.

Side effect rates were similar among patients treated with PUL and WAVE.

This study concluded that PUL and WAVE provided similar improvements in symptoms and QoL in patients with BPH, while WAVE improved the urinary flow rate and durability of response.

The data was collected from a small number of trials. The 2 procedures were not directly compared. A randomized controlled trial is needed to confirm these results.