A comparative analysis of the outcomes of Rezūm therapy based on prostate size: a four-year retrospective analysis

To assess the safety and efficacy of Rezūm therapy in small versus large prostates through a four-year follow-up.

One-hundred seventy patients who underwent Rezūm therapy were retrospectively included and divided into 2 equal groups, small (˂ 80gm) and large prostate groups (80-120 gm). Both groups were assessed preoperatively and at 3, 12, 24, 36, and 48 months post-procedure for operative time, number of vapor injection, catheterization time, hospital stay and post-procedure: prostatic size, prostate-specific antigen (PSA), post-void residual (PVR), maximum urinary flow rate (Qmax), International Prostate Symptom Score (IPSS), quality of life (QoL), International Index of Erectile Function (IIEF) and complications.

The number of vapor injections was significantly higher in the large prostate group compared to the small prostate group (p < 0.001). Operative time and catheter duration were significantly longer in the large prostate group (p < 0.001), while hospital stay was similar between groups (p = 0.407). At 48 months post-Rezūm, both groups demonstrated statistically significant improvement in all measured outcomes (Qmax, IPSS, PVR, QoL, PSA, IIEF, and prostate size) (p < 0.05). Regarding postoperative complications, there were no significant differences between the groups except that the need for retreatment was significantly higher in the large prostate group.

Rezūm therapy offers a safe and effective treatment option for both small and large prostates with sustained improvement over four years. However, patients with large prostates exhibited a higher retreatment rate (15.2%).