Expert consensus on Rezūm™: Indications, surgical technique and postoperative care

Area of Science:

• Urology
• Minimally Invasive Surgery
• BPH Management

Background:

• Lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH) present a significant clinical and economic burden.
• Current treatments for LUTS/BPH include pharmacological and surgical options, with emerging minimally invasive therapies still facing limitations.
• Water Vapour Thermal Therapy (WVTT), Rezum™, is a novel minimally invasive technique offering a low retreatment rate and preserving sexual function.

Purpose of the Study:

• To establish recommendations for the correct execution of WVTT.
• To define the ideal patient profile for WVTT intervention.

Main Methods:

• A systematic literature review was conducted using PubMed with relevant keywords.
• Evidence from 49 analyzed articles was discussed by a panel of five urology experts.
• The review focused on patient profile, pre-intervention, intervention, and post-intervention aspects.

Main Results:

• WVTT is suitable for patients with moderate to severe LUTS/BPH, regardless of age, with Qmax <15 mL/s and prostate volume >30 cm³ (not necessarily <80 cm³).
• The therapy demonstrated a low retreatment rate.
• WVTT showed minimal impact on erectile and ejaculatory function.

Conclusions:

• WVTT is a safe treatment option, potentially a first-line approach for selected patients with LUTS/BPH.
• Further research is required for postoperative catheter management, anesthesia, antibiotic prophylaxis, and follow-up care.
• WVTT offers a valuable alternative for managing benign prostatic hyperplasia symptoms with preserved sexual function.