Category: BPH/LUTS: Outcomes & Complications

MP11-13 - 3-year treatment outcomes of water vapor thermal therapy compared to doxazosin, finasteride and combination drug therapy for men with BPH: cohort data from the Medical Therapy of Prostatic Symptoms (MTOPS) Trial

Fri, Sep 21
2:00 PM - 4:00 PM

Introduction & Objective :

This evaluation of the long-term outcomes of treatment for lower urinary tract symptoms due to benign prostatic hyperplasia compares a one-time water vapor thermal therapy procedure with daily medical therapy in cohorts from the Medical Therapy of Prostatic Symptoms (MTOPS) study.

Methods :

Results from the treatment arm of a randomized, controlled trial of thermal therapy (Rezūm System) were compared to MTOPS subjects treated with doxazosin, finasteride, or both. Evaluations were restricted to medical therapy subjects (1,146 of original 3,047; 37.6%) with prostate volume 30 to 80 cc, International Prostate Symptom Score of 13 or greater to include subjects that met key criteria of both Rezūm II and MTOPS trials.  Outcomes were compared over 3 years for symptom changes and rates of clinical progression.

Results : The rate of clinical progression over 3 years for any medical therapy was five times greater than after the single water vapor thermal therapy procedure.  Thermal therapy improved symptom scores by ~50% throughout 36 months, p<0.0001; symptom improvement was greater than with either drug alone (p<0.02) but similar to combination drugs (p =0.6321). Peak flow rate improved 4 to 5 mL/s after both Rezūm and doxazosin, whereas Rezūm was superior to finasteride for 24 months and combination drugs for 12 months (p<0.02).

Conclusions : The delayed clinical progression and effective and durable improvements in symptom scores after a single water vapor thermal therapy procedure warrants consideration of this procedure as the initial therapeutic modality as an alternative to long-term use of pharmaceutical agents. 

Kevin McVary

Professor of Urology, Director of Men's Health
Loyola University Medical School
Loyola University Medical School
Springfield, Illinois

Joseph Mahon

Andrology Fellow
Springfield, Illinois

Nikhil Gupta

Assistant Professor of Urology
Robert Wood Johnson Medical School
New Brunswick, New Jersey

Tyson Rogers

2NAMSA, Minneapolis, Minnesota

Bradley Holland

Springfield, Illinois