Rezūm Therapy in Very Elderly Men With BPH: Two-Year Outcomes From a Multicenter Cohort

Rezūm water vapor thermal therapy is a minimally invasive surgical option with demonstrated efficacy and safety. However, real-world evidence on 2-year outcomes in the population aged above 80 years remains limited.

A prospective registry was created as part of the International Rezūm Registry database at two high-volume centers. Data were reviewed from patients monitored between April 2019 and August 2024. Men aged ≥ 80 years who underwent Rezūm therapy were included. Baseline and follow-up assessments at 3, 6, 12, and 24 months included International Prostate Symptom Score (IPSS), IPSS Quality of Life (QoL) subscore, peak urinary flow rate (Qmax), and post-void residual volume (PVR). Safety outcomes and adverse events were also recorded.

Fifty-eight patients (mean age 84.4 ± 4.4 years) were included, with a mean prostate volume of 80.1 ± 42.1 cc. The mean IPSS decreased from 19.8 ± 7.4 at baseline to 12.4 ± 7.9 at 24 months. The IPSS quality of life (QoL) score declined from 4.2 ± 1.8 at baseline to 2.6 ± 1.5 at the corresponding follow-up interval. Qmax improved from 8.5 ± 5.8 mL/s at baseline to 15.0 ± 4.0 mL/s at 24 months, respectively. PVR was reduced from 115.5 ± 93.7 mL at baseline to 42.8 ± 29.2 mL over the same period. However, neither Qmax nor PVR demonstrated a statistically significant change at any time point. Adverse events were infrequent, with urinary tract infections (8.6%), epididymitis (5.2%), and acute urinary retention (3.4%). Only one patient required hospitalization.

Rezūm water vapor thermal therapy is a safe and effective treatment for BPH in patients over 80 years of age. It results in durable improvements in urinary symptoms and function with a low rate of complications.