Two-Year Outcomes of Rezūm Therapy in Real-Life BPH Patients

Rezūm therapy is a minimally invasive treatment for male lower urinary tract symptoms (LUTS) related to benign prostatic obstruction (BPO), validated in selected patients through randomized trials. However, its effectiveness in broader real-world populations remains underreported.

This single-center retrospective study included 110 patients treated with Rezūm between 2020 and 2022. Patients were stratified according to their conformity to the original trial criteria ("pilot" vs. "nonpilot" groups). Functional outcomes, retreatment rates, sexual function and adverse events were analyzed at 24 months.

At 24 months, both groups experienced a significant and sustained reduction in IPSS from baseline, with a median decrease of 18 points (IQR: 15-20) in the pilot group and 19 points (IQR: 16-22) in the non-pilot group (p = 0.2). Improvements in IPSS-QoL, Q_max, and PVR were also significant and comparable between groups. Overall, 23% of patients required retreatment: 24% in the pilot group and 24% in the non-pilot group (p = 0.9), including medical retreatment in 15% and 5%, and surgical retreatment in 8% and 16%, respectively (p = 0.2). No independent predictor of retreatment was identified. Ejaculatory function was preserved in over 90% of patients at 24 months in both groups, and erectile function remained stable throughout follow-up.

Rezūm therapy provides effective, durable symptom relief and preserves sexual function at 2 years, even in patients with larger prostates, prior surgery, or indwelling catheters.