Category: BPH/LUTS: Outcomes & Complications
Introduction & Objective :
Convective radiofrequency water vapor thermal therapy has recently been approved as a minimally invasive technique to treat benign prostatic hyperplasia (BPH). We present our initial experience utilizing the Rezūm system in a tertiary care center.
We retrospectively reviewed 150 patient charts that underwent Rezūm therapy by three BPH surgeons since July 2017. Post-procedure catheterization regimen included a minimum of 3 days and a maximum of 4 weeks in men with preoperative catheter dependence. Large glands (≥80 g) utilized stacked treatments and often received the max 15 Rezūm treatments per device. Post-operative results were compared by t-test and chi-squared analysis.
Outcomes are reported in Table 1. Briefly, the average prostate gland size was 66.2 grams. During this time, 34 patients were treated with large glands. Fifty seven patients were catheter dependent preoperatively. Of these, 47 (82.4%) patients no longer required catheterization at follow up. Significant improvements were seen in AUA symptom score, peak flow, and post void residual (p<0.001). Post-operative infections occurred in 14% of patients (21/150) with significant infections requiring admission occurring in 8 men. Patients with small prostates (p=0.037) and those with history of previous infections (p=0.047) were associated with infectious complications. Bleeding complications were very rare despite continued anti-coagulation in 55 men. No men reported new onset ED.
Our initial experience with the Rezūm prostate ablation demonstrates improvement in both symptomatology and urodynamic findings. The procedure resolved urinary retention in 81% of catheter dependent men. Higher than expected rates of UTI were seen influencing patient counseling and post procedure antibiotic regimen.
David Yang– Urology Resident, Department of Urology, Mayo Clinic, Rochester, MN, Rochester, Minnesota
Ross Avant– Rochester, Minnesota
Ajay Gopalakrishna– Rochester, Minnesota
Sevann Helo– Rochester, Minnesota
Kevin Hebert– Resident Physician, Mayo Clinic (Rochester), Rochester, Minnesota
Manaf Alom– Rochester, Minnesota
Tobias Kohler– Rochester, Minnesota
Department of Urology, Mayo Clinic, Rochester, MN