Comparing water vapor thermal therapy and prostatic urethral lift in the treatment of benign prostatic hyperplasia

This study compared water vapor thermal therapy using the Rezum system and prostatic urethral lift (PUL) in the treatment of men with urinary symptoms from benign prostatic hyperplasia (BPH). Researchers suggested that both treatments improve symptoms and the quality of life of these patients. 

Benign prostatic hyperplasia (BPH) consists of the enlargement of the prostate and is common as men get older. It can cause urinary symptoms such as incomplete urination, dribbling, inability to pass urine. These symptoms are usually caused by prostate tissue growth that is blocking the flow of urine out of the bladder. Prostate surgery is the standard care for BPH. However, it is associated with a high risk for side effects. Minimal invasive techniques such as water vapor therapy or PUL are studied to replace prostate surgery.

Water vapor thermal therapy uses thermal heat to destroy excess prostate tissue. PUL consists of separating the prostate lobes to make the urethra (the tube that passes urine out of the bladder) wider so that it is easier to urinate.

Prior studies have only compared the effectiveness of these minimally invasive techniques to other treatments such as prostate surgery. Therefore, no studies have directly compared the effectiveness of water vapor thermal therapy and PUL in patients with BPH.

This study included information about 117 patients. Of these, 61 (52.1%) received water thermal therapy (group 1), and 56 (47.9%) received PUL (group 2). Patients had prostates smaller than 80 mL. The main outcome measured was the change in prostate symptoms and quality of life from the start of the treatment to 12 months.

No serious side effects were reported in both groups. Surgical time was significantly lower in group 1. However, patients in group 1 had slightly more complications such as bloody urine, urinary retention, and infection. At 12 months, group 1 reported a slightly greater improvement in prostate symptoms when compared to group 2. Quality of life had a similar improvement at 12 months. 

Group 2 had a re-treatment rate of 25% and group 1 of 8.3%. Sexual function rates did not change significantly in either group. Patients from group 1 had greater improvements in prostatic symptoms, quality of life, and re-treatment rate than group 2. 

This study concluded that water vapor thermal therapy improves BPH symptoms and quality of life when compared to PUL. 

This study was based on medical records. Information might be missing and study results might not be accurate. Further studies are necessary.