Modified water vapor thermal therapy for large-volume benign prostatic hyperplasia

This study aims to evaluate the efficacy and safety of modified water vapor thermal therapy for large-volume benign prostatic hyperplasia (BPH).

This prospective study enrolled 196 consecutive patients with prostate volume ≥ 80 mL who underwent modified water vapor thermal therapy at our institution between October 2023 and September 2024. All procedures were performed using the Rezum system.

The procedures were successfully completed in all 196 patients with a median prostate volume of 96 mL. The IPSS decreased from a preoperative mean of 21.2 ± 3.9 to 11.7 ± 3.4 at 3 months, and further improving to 10.8 ± 3.8 at 1 year. Median prostate volume reduced from 96 mL to 60 mL. The QoL score improved from 4.3 ± 0.9 to 1.7 ± 1.1, and Qmax increased from 8.3 ± 2.3 mL/s to 15.7 ± 3.5 mL/s at 3 months. All observed improvements were statistically significant compared to baseline (P < 0.01). The IIEF-5 score increased from 11.0 ± 3.6 to 14.1 ± 5.4 at 1 year, indicating a statistically significant improvement in erectile function (P < 0.05). The incidence of retrograde ejaculation was 3.1%. Only one patient (0.5%) required surgical retreatment during the follow-up period.

Modified water vapor thermal therapy demonstrates favorable efficacy and safety in the treatment of large-volume BPH. It is associated with significant symptom relief, functional improvement, and minimal complications.