Transurethral convective radiofrequency water vapour thermal therapy of the prostate (Rezum) for men with lower urinary tract symptoms related to benign prostatic hyperplasia at a single institution: a pilot study and initial outcomes

Abstract

Objectives: Rezum is a new minimally-invasive surgical technology, which utilizes radiofrequencygenerated water vapour to ablate prostate tissue for benign prostatic hyperplasia (BPH). This study evaluates its safety and efficacy in Hong Kong. Patients & Methods: A prospective cohort of BPH patients treated with Rezum at a single institution between January 2020 to July 2021 was analysed. Efficacy was evaluated using international prostate symptom score (IPSS), quality-of-life score (IPSS-QoL), uroflowmetry and postvoid residual (PVR) volumes, Overactive Bladder Questionnaire-Short Form (OAB-q SF), international index of erectile function (IIEF-5) questionnaire, male sexual-health questionnaire for ejaculatory dysfunction. All patients had transrectal-ultrasound prostate volume estimation. Patients with maximum flow-rate (Qmax) <15ml/s, IPSS ≥13, PVR<250ml and prostate volume 30-120cc were eligible. Results: Thirty-three patients were eligible with a median follow-up of 8 months. Mean age was 65.7. Mean prostate volume was 59.8cc. 21(68%) carried out under sedation. Mean operative time was 14 minutes (range 6 – 28). Thirty-one (94%) patients were discharged on the same day. Post-operative median catheter-indwelling time was 6 days (range 1 – 10). Rezum significantly improved IPSS by mean of -12.13 (56%), IPSS-QoL of -2.2 (49%), Qmax of 5.5ml/s (68%). None of the 18 sexually-active men reported erectile or ejaculatory dysfunction. 9.1% reported transient dysuria. One patient required re-admission for haematuria. 2 (6%) had post-op UTI. One patient had to resume alpha-blocker, and one required redo-Rezum. Conclusion: Rezum is a feasible option for men with significant LUTS caused by BPH. This study demonstrated its excellent short-term efficacy, safety and functional outcomes in Hong Kong.