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Injection density in Rezūm®: Less might not be more. A multicentric international study.

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|August 2, 2025
PubMed
Summary
This summary is machine-generated.

Optimizing injection density (ID) in Water Vapor Thermal Therapy (WVTT) for benign prostatic obstruction may improve treatment success. Higher ID showed a protective effect against failure without increasing complications or impacting sexual function.

Keywords:
Benign prostatic obstructionDensidad de inyecciónHiperplasia prostática benignaInjection densityLower urinary tract symptomsMinimally invasive surgical therapyRezum®Rezūm®Síntomas de tracto urinario inferiorTerapia térmica con vapor de aguaWater vapor thermal therapy

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Area of Science:

  • Urology
  • Minimally Invasive Surgery

Background:

  • Water Vapor Thermal Therapy (WVTT) is a minimally invasive surgical therapy (MIST) for benign prostatic obstruction.
  • The optimal number of intraprostatic injections for WVTT is not well-defined.
  • This study introduces injection density (ID) as a metric to evaluate WVTT outcomes.

Purpose of the Study:

  • To assess the impact of injection density (ID) on treatment failure after WVTT for benign prostatic obstruction.
  • To determine the relationship between ID and postoperative complications and sexual function.

Main Methods:

  • Multicentric retrospective study of 722 patients undergoing WVTT across 11 European centers.
  • Data collected included baseline, surgical, and 24-month postoperative outcomes.
  • Logistic regression analyzed treatment failure based on ID cut-off points (0.75-2.5 injections/10 cc).

Main Results:

  • Intermediate ID (1.25-1.75 injections/10 cc) showed a protective effect against treatment failure, with 1.75 reaching statistical significance (P=.028).
  • Higher ID (2.00-2.50 injections/10 cc) also demonstrated a protective effect, with 2.25 reaching significance (P=.024).
  • No significant association was found between ID and complications; sexual function remained stable.

Conclusions:

  • Optimizing injection density (ID) in WVTT may enhance treatment success rates for benign prostatic obstruction.
  • A volumetric approach to WVTT, guided by ID, may offer improved outcomes compared to linear injection techniques.
  • Higher ID can be safely implemented without adverse effects on complications or sexual function.