Convective radiofrequency water vapor thermal therapy for benign prostatic hyperplasia: a single office experience

Convective radiofrequency water vapor thermal therapy with the Rezūm system is a relatively new treatment for benign prostatic hyperplasia (BPH). We present results from a single surgeon in an office setting.

A retrospective review of 129 patients from a single surgeon who underwent the Rezūm procedure was performed. All patients were at least 4 months out from treatment. International prostate symptom scores (IPSS), maximum flow rates (Qmax), residual urine volumes, medication usage, and adverse events were monitored. Data were analyzed at baseline, 15-45 days, 46-90 days, and 91-180 days after treatment. A scripted patient questionnaire was attempted over the phone to all patients. It was administered by a resident and medical student who do not work in the provider's office.

Maximal effects were noted at the 91-180 day interval. IPSS improved from a baseline of 18.3 to 6.9 and Qmax from 10.5 to 16.8 mL/s. Improvements were independent of starting symptom score, median lobe treatment, and prostate size. There was a 17% prostate volume reduction based on TRUS and 14% based on PSA. The most common adverse events were urinary tract infections (17%) and transient urinary retention (14%). In total 90% of patients were able to come off their BPH medications and 86% of patients would recommend the procedure to a friend.

Rezūm radiofrequency water vapor thermal therapy offers a minimally invasive option for BPH management with moderate improvement in symptoms and flow rate. The results appear to be independent of prostate size or presence of a median lobe, and have now been replicated in a single office setting.