The following article features coverage from the American Urological Association (AUA) 2019 meeting. Click here to read more of Renal & Urology News’ conference coverage.

CHICAGO—Rezum water vapor ablation, a minimally invasive procedure for treating benign prostatic hyperplasia (BPH), relieves lower urinary tract symptoms (LUTS) for at least 1 year with low morbidity, investigators reported at the 2019 American Urological Association annual meeting.

Rezum, which uses convective heating to ablate prostate tissue, is indicated for men aged 50 years and older with a prostate volume 30 to 80 mL.

In a prospective case series from the United Kingdom, 181 patients (mean age 67 years) with prostate volumes of 20 to 121 mL and moderate to severe LUTS underwent the water vapor therapy. Of these, 123 had obstructing median lobes and 16 patients had urinary retention.

A total of 131 day case procedures were performed under local anesthetic with sedation,
Richard Hindley, MB ChB, of Hampshire Hospitals NHS Foundation Trust, and his colleagues reported. A mean 5.8 steam injections were made during a mean operative time of 17.5 minutes. Patients experienced moderate symptom improvement within 4 to 6 weeks. By 3 and 6 months, flow rate (6.5 mL/s), post void residual, IPSS (-14.9 points), quality of life, and prostate volume all improved.

Within 6 months, mean gland volume had shrunk by 35%. Three quarters of patients passed their first trial without a catheter and 96% were catheter free at 3 months. No changes in erectile function were reported.

With respect to complications, urinary tract infections requiring antibiotic treatment developed in 8 patients, 3 patients required a procedure for secondary hemorrhage or resection of infected prostate tissue, 1 was admitted to a high-dependency unit, and 2 required additional surgery for ongoing LUTS at 6 months.

“This minimally invasive therapy provides men with a reliable volume reducing treatment option with an impressive side-effect profile,” Dr Hindley told Renal & Urology News. “The UK results are in line with the US experience, both in terms of the degree and profile of the symptomatic improvement.”

The investigators are planning longer follow-up to assess durability of the results. They also encouraged comparison of the Rezum system with other BPH treatments and cost-effectiveness analysis.

Reference

Johnston M, Shah T, Emara A, et al. Rezūm water vapour ablation therapy for benign prostatic hyperplasia: Initial results from the United Kingdom. Presented at the 2019 American Urological Association annual meeting held May 3-6 in Chicago. Poster MP01-03.