|The following article is part of conference coverage from the 2017 American Urological Association meeting in Boston. Renal and Urology News’ staff will be reporting live on medical studies conducted by urologists and other specialists who are tops in their field in kidney stones, prostate cancer, kidney cancer, bladder cancer, enlarged prostate, and more. Check back for the latest news from AUA 2017.|
BOSTON—A minimally invasive therapy that uses water vapor to ablate prostate tissue can effectively treat recalcitrant urinary retention in men with lower urinary tract symptoms secondary to benign prostatic hyperplasia (BPH), according to data presented at the American Urological Association 2017 annual meeting.
In a study, convective radiofrequency water vapor energy prostate ablation (Rezum), 43 (81.1%) of 53 BPH sufferers with urinary retention were catheter-free after months of being dependent on a catheter, a team led by Kevin T. McVary, MD, Chair and Professor of Urology at Southern Illinois University (SIU) School of Medicine in Springfield, reported. The men were catheter-free after an average of 28 days post-procedure.
Preoperatively, the cohort, which was selected from an international registry founded at SIU, had a mean age of 77 years, mean prostate size of 64.5 mL, and mean post-void residual (PVR) of 614 mL. After the ablation procedure, the mean PVR dropped to 116 mL. The mean post-procedure International Prostate Symptom Score (IPSS) for the cohort was 9. The primary endpoint of the study was successful trial without catheter (TWOC).
Among the men who had a successful TWOC, the mean PVR decreased from 506 mL before the procedure to 97 mL afterward.
The investigators cited studies showing that the rates of urinary retention in BPH/LUTS patients are as high as 35.9 per 1000 person-years, and 67% of patients with the condition undergo surgery after spontaneous urinary retention within 4 years. They noted that men in urinary retention are typically excluded from all randomized controlled trials for standard surgical procedure trials and pharmaceutical trials, as well as minimally invasive surgical treatments.
“Men in urinary retention are a special understudied group because they tend to be older, frailer, with larger prostates, and difficult to successfully treat,” Dr McVary told Renal & Urology News. “Understanding them better and finding new minimally invasive ways to safely free them from the rigors, discomfort and complications of a catheter dependent life is an unmet need in urology. This international registry founded at SIU opens the door to exam a new way to measure the clinical impact of this new technology.”
Holland BC, Gupta N, Delfino K, et al. Convective radiofrequency water vapor energy prostate ablation (Rezum) effectively treats urinary retention. [abstract] J Urol 2017;197(4S):e337. Poster presented at the American Urological Association 2017 annual meeting in Boston on May 13, 2017. Poster MP27-20.