Change in prostate volume reduction and symptomatic improvement in men treated with Rezūm convective water vapour thermal thera

Abstract

Background: Rezūm convective water vapour thermal therapy is a minimally invasive, office-based treatment for benign prostatic hyperplasia (BPH). While studies have demonstrated its efficacy in symptomatic improvement, its effect on objective measures such as prostate volume (PV) reduction is poorly characterized. The purpose of this study was to evaluate the change in PV and its relationship to improvement in symptom scores following Rezūm therapy. Methods: Quality of life outcomes and PV were assessed at baseline and 12 months post-procedure. The percent change from baseline in outcomes and PV were calculated for each patient, as was the injection to baseline volume ratio. The association between the total number of vapour injections and changes in outcomes and PV were evaluated using linear regression models. Results: A total of 49 patients (mean age = 67.8; standard deviation [SD] = 9.4) underwent the procedure between April 2019 and September 2020, with a median baseline PV of 71.5 and median number of vapour injections of 11.0. At 12 months, the median percent change in prostate volume was -34.0% (interquartile range: -49.2%, -16.7%), with 45/49 (91.8%) patients having reduced volume. Among the 45 patients with reduced volume at 12 months, every 10% increase in volume reduction was associated with a 7.5% (95% confidence interval, 1.4% to 13.6%; p=0.02) improvement in the International Prostate Symptom Score. There was no significant association between the total number of injections or injection to baseline volume ratio and change in PV. Conclusions: In this cohort of patients treated with Rezūm convective water vapour thermal therapy for BPH, it was demonstrated that there is a correlation between greater PV reduction and greater symptomatic improvement. Additionally, this study showed no association between more injections or the ratio of injections to prostate volume changes, refuting the claim that more injections are better.