Water Vapor Energy Therapy Safely Reduces Urinary Medication Use: A Multicenter Retrospective Real-World Study in...

The Japanese guidelines for male lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH) recommend the water vapor energy therapy (WAVE) procedure only for patients in whom conventional BPH surgery is unsuitable due to advanced age or comorbidities. This study aims to evaluate the efficacy and safety of the WAVE procedure using the Rezum system in Japan.

This multicenter retrospective study included patients who underwent the WAVE procedure between August 2022 and December 2023. A total of 311 patients from 13 institutions were registered. The number of medications for LUTS was determined before surgery and 6 months after surgery. Additionally, voiding function and perioperative complications were analyzed.

Of the 311 patients, 291 were eligible for analysis. The mean number of LUTS medications significantly decreased from 1.4 to 0.6 (p < 0.001). The mean maximum urinary flow rate significantly improved from 9.8 mL/s preoperatively to 12.2 mL/s at 6 months postoperatively (p < 0.001). The mean post-void residual volume also significantly decreased from 124 to 78 mL (p < 0.001). Furthermore, the mean total International Prostate Symptom Score significantly improved from 17.8 to 8.9 (p < 0.001). Complications classified as Clavien-Dindo Grade III or higher occurred in four cases (1.2%).

This large-scale, multicenter study demonstrates that the WAVE procedure improves LUTS, reduces the number of LUTS medications, and is both effective and safe for elderly patients with multiple comorbidities in Japan.