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

ABSTRACT

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.