Large, Multi-Center, Prospective Registry of Rezūm Water Vapor Therapy for Benign Prostatic Hyperplasia

To illustrate the role of Rezūm convective water vapor ablation for treatment of lower urinary tract symptoms secondary to Benign prostatic hyperplasia.

A prospective registry was established for Rezūm therapy in Canada at two high-volume centers. All patients had baseline medical and Benign prostatic hyperplasia history documented, along with uroflowmetry and validated questionnaires up to 12 months post-surgery.

229 patients (mean age 67.3 years), including 83 with prostate volumes ≥80 mL, were treated from April 2019 to December 2020. The mean prostate volume was 71.5 mL (range 20-160 mL) and 55% had a median lobe. The mean number of injections was 11 (range: 4-28) and mean procedural length was 4.8 minutes (range: 1.5-14). The mean duration of postprocedure catheterization was 9.8 days. International Prostate Symptom Scores improved from baseline by 29%, 53%, and 59% at 1, 3, and 12 months, respectively. International Prostate Symptom Scores quality of life improved from baseline by 30%, 50%, and 67% at 1, 3, and 12 months, respectively. Qmax improved by 60% at 3 months and 74% at 12 months. Post-void residual volume improved by 51% and 61% at 3 and 12 months, respectively. No statistically significant changes were seen in International Index of Erectile Function-15 or Male Sexual Health Questionnaire for Ejaculatory Dysfunction scores. No Clavien-Dindo events ≥Grade III occurred.

Rezūm therapy is a safe, effective, and quick outpatient procedure for prostate glands over a wide range of volumes. Clinically significant improvements are seen in all validated questionnaires. Objective maximum flow measures improved, while erectile and ejaculatory function remains preserved.