Postoperative Outcomes Following Rezum: A Novel Minimally Invasive Therapy for Benign Prostatic Hyperplasia (BPH)

This study aimed to analyze and evaluate the effectiveness and safety of Rezum (water vaporization of the prostate), a minimally invasive treatment for managing lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH), with a focus on postoperative outcomes.  Methodology: Seventy-three patients meeting the inclusion criteria were enrolled in the study at Leicester General Hospital (University Hospitals of Leicester NHS (UHL), NHS trust), Leicester, England, from 1^st August 2023 to 31^st August 2024. In this prospective cohort study, the following variables were recorded: name, date of birth, date of admission, pre-/postoperative International Prostate Symptom Score (IPSS), pre-/postoperative Quality of Life Score (QOLS), pre-/postoperative International Index of Erectile Function (IIEF-5), prostate size, urodynamics, prostate-specific antigen (PSA) level, Rezum injections, anesthesia, post-procedure side effects and symptoms on follow-up, recommendations to family and friends, and status on discharge. To assess the procedure outcomes, these variables were analyzed using IBM SPSS Statistics, version 23 (IBM Corp., Armonk, NY), and the results were depicted in the form of graphs, charts, and tables.  Results: In our study, the mean preoperative IPSS was 22.6 ± 7.5, reduced to 12.8 ± 9.4, showing a 27% improvement. The highest pre-procedure QOLS was five (n=19, 26.4%), compared to three (n=21, 29.2%) after Rezum, representing a 33.3% improvement. Preoperative assessment of erectile function, as measured by the IIEF-5 with a maximum possible score of 25, revealed a mean score of 15.1 ± 1.1. Post-operative evaluation indicated a slight decline, with the mean score decreasing to 14.7 ± 4.03, reflecting a 1.5% reduction in erectile function. The reduction in symptomatic LUTS showed a statistically significant improvement with injections targeting the left side and the median lobe (p = 0.002). Furthermore, a statistically significant correlation was observed between Rezum injections targeting the median lobe and post-procedure quality of life (p = 0.003).

Through this single-center retrospective cohort, we concluded that Rezum is a minimally invasive outpatient procedure that offers safe and effective treatment for LUTS. It has a low side-effect profile and preserves sexual function. Further long-term studies are recommended.