Is the rezum treatment effective in patients with BPH complicated by urinary chronic retention? Our preliminary experience

Author of the study: Rezum is one of the most promising minimally invasive technologies for the treatment of BPH. During Covid pandemic era we used this technique extending the indication even in patients carryng urinary catheter or in patients with prostatic adenoma volume higher than 80 ml. In this short communication we report the preliminary results of our experience. Material(s) and Method(s): From January 2019 to September 2021 92 patients underwent a Rezum treatment. Of these patients 51 (55%) carrying catheter for urinary retention secondary to BPH. Inclusion criteria was: age >18 yo, catheterization time >3 months, prostate adenoma volume >30 cc. A 6 months follow up was offered to each patient including uroflometry and PSA. Result(s): Mean age was 75 yo (62-84), mean iPSA 3,7 ng/ml (1,9-5,8), mean adenoma volume 92 cc(65-270). Mean catheterization time before treatment 7,8 months (3-14). Mean operative time (12,5 min (11-14). All patients were discharged 4 hours after the treatment. Catheter removal was performed after 4/6 weeks. 48 (94%) patients obtained a spontaneous micturition. Mean Qmax at 6 months 12,5 cc/ sec, mean Post-void residual 120 cc. In 3 patients we observed post operative IVU treated with antibiotics. 21 (44%) patients continue alpha-litic therapy after Rezum treatment. In 2 patients it was necessary performing a disobstructive surgery. Conclusion(s): Rezum may represent a possible minimally invasive therapeutic strategy for BPH complicated by urinary chronic retention whenever other procedures aren't feasible. Despite the technical card indications, we successfully treated even prostate adenoma volumes higher than 80 ml. In some cases oral therapy was still necessary after the procedure. Our preliminary results are encouraging to continue to performing this procedure in these patients but further studies with longer follow up are needed Copyright © 2022 European Association of Urology. Published by Elsevier B.V.

[Efficacy of serological tests for COVID-19 in asymptomatic HD patients: the experience of an Italian hemodialysis unit]

We report the brief experience of the Nephrology Center located in a "no-COVID" Hospital in Massa Marittima. We describe the actions taken to prevent the transmission of the virus SARS-CoV-2 among hemodialysis patients and healthcare workers and the methods for diagnosing COVID-19, with particular attention to serological tests and nasopharyngeal swabs in asymptomatic subjects. The detection of IgM and IgG antibodies through the serological test performed on 34 patients, all negative for nasopharyngeal swabs, showed positivity in 41,18% of cases. These have been classified as false positives following repeated negative nasopharyngeal swabs, the evaluation of clinical and epidemiological history and of clinical manifestations and, finally, a second serological test performed after 18 days, which resulted negative for all patients. Interpreting serological tests is not easy;the strategies for diagnosis should include clinical and epidemiological history and clinical manifestations, as well as the results of confirmation tests and the evaluation over a precise observation period. Otherwise, there is a risk of considering as protected by antibodies subjects that are in fact false positives.