Comparative Postoperative Outcomes of Rezūm Prostate Ablation in Patients with Large Versus Small Glands

Bole, Raevti; Gopalakrishna, Ajay; Kuang, Ruby; Alamiri, Jamal; Yang, David Y.; Helo, Sevann; Ziegelmann, Matthew; Köhler, Tobias

doi:10.1089/end.2020.0177

Cited by 45 publications

(57 citation statements)

References 13 publications

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“…Further, median follow-up for these metrics exceeded 90 days, offering a glimpse at potential durability of these improvements. Conversely, Rezum did not significantly reduce rates of intermittent catheterization, which contrasts Bole et al's findings [15]. This is also the first study to report on the medical management of LP men after Rezum.…”

Section: Discussioncontrasting

confidence: 78%

“…This series represents the second study documenting outcomes of patients with large (≥ 80 cc) prostates following Rezum. Bole et al reported 3 months outcomes in LP patients who underwent Rezum [15]. For the present study, of the 36 patients that met inclusion criteria, mean preoperative prostate size was 106.8 cc, 22% were catheterdependent at the time of procedure, and 97% were being managed medically with an AB, 5ARi, AS, PDE5i, or some combination thereof.…”

Section: Discussionmentioning

confidence: 89%

“…However, Rezum can theoretically also be a viable option for men with LP, though this is a largely unexplored area of interest. Bole et al recently published the first report on the use of Rezum for prostates ≥ 80 cc, preliminarily demonstrating its short-term safety and efficacy for LP men [15].…”

Section: Introductionmentioning

confidence: 99%

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Rezum therapy for patients with large prostates (≥ 80 g): initial clinical experience and postoperative outcomes

et al. 2021

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Purpose Rezum is a minimally invasive surgery for benign prostatic hyperplasia. Current guidelines recommend Rezum for prostates < 80 cc, but little data exist describing outcomes in patients with prostates ≥ 80 cc. We compare outcomes after Rezum between men with small < 80 cc (SP) and large ≥ 80 cc prostates (LP). Methods Patients undergoing Rezum between Jan 2017-Feb 2020 were subdivided by prostate volume (< 80, ≥ 80 cc). Outcomes were documented pre-and postoperatively. Descriptive analyses of urodynamics data (Qmax, PVR), symptom scores (AUA-SS, SHIM), disease management (medications, catheterization, retreatments), and clinical outcomes were conducted. Results 36 (17.6%) men had prostates ≥ 80 cc (LP mean prostate size 106.8 cc). LP men had improved Qmax and PVR postoperatively; those with longitudinal follow-up exhibited improved Qmax, PVR, and AUA-SS. After one year, alphablocker usage decreased significantly (LP 94.44-61.11%, p = 0.001, SP 73.96-46.15%, p = 0.001); other medication usage and self-catheterization rates remained unchanged. Compared to SP patients, differences in passing trial void (LP 94.44%, SP 93.45%), postoperative UTI (LP 19.44%, SP 10.12%), ED visits (LP 22.22%, SP 17.86%), readmissions (LP 8.33%, SP 4.76%), and retreatment (LP 8.33%, SP 4.76%) were insignificant. However, mean days to foley removal (LP 9, SP 5.71, p = 0.003) and urosepsis rates (LP 5.56%, SP 0.00%, p = 0.002) differed. Conclusion In select LP patients, Rezum provided short-term symptomatic relief and improved voiding function comparable to SP patients. Postoperatively, though alpha-blocker usage decreased significantly, use of other medications did not change, and nearly two-thirds of patients still needed alpha-blockade. Further efforts should explore the possibility of expanding Rezum's inclusion criteria.

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Section: Discussioncontrasting

confidence: 78%

Section: Discussionmentioning

confidence: 89%

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Rezum therapy for patients with large prostates (≥ 80 g): initial clinical experience and postoperative outcomes

et al. 2021

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“…McVary et al found that patients with treated median lobe enlargement had objective and subjective improvements similar to those without an identified median lobe [18]. Other studies present similar findings in which functional outcome improvement is independent of prostate size and presence of median lobe [21,31]. Notwithstanding, Darson et al noted a mean IPSS decrease of 10.1 and 9.4 points at 3-6 months and 12 months, respectively, among 54 patients that had a median lobe [20].…”

Section: Discussionmentioning

confidence: 82%

Reasons for new MIS. Let's be fair: iTIND, Urolift and Rezūm

et al. 2020

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Purpose To review and discuss the literature regarding iTIND, Urolift and Rezūm and investigate the precise clinical indications of all three different approaches for their application in benign prostatic hyperplasia (BPH) treatment. Materials and methods The PubMed–Medline and Cochrane Library databases were screened to identify recent English literature relevant to iTIND, Urolift and Rezūm therapies. The surgical technique and clinical results for each approach were summarized narratively. Results iTIND, Urolift and Rezūm are safe and effective minimally invasive procedures for the symptomatic relief of lower urinary tract symptoms (LUTS) due to BPH. iTIND requires the results of ongoing prospective studies, a long-term follow-up and a comparison against a reference technique to confirm the generalizability of the first pivotal study. Urolift provides symptomatic relief but the improvements are inferior to TURP at 24 months and long-term retreatments have not been evaluated. Rezūm requires randomized controlled trials against a reference technique to confirm the first promising clinical results. However, clinical evidence from prospective clinical trials demonstrates the efficacy and safety of these procedures in patients with small- and medium-sized prostates. Conclusions Although iTIND, Urolift, and Rezūm cannot be applied to all bladder outlet obstruction (BOO) cases resulting from BPH, they provide a safe alternative for carefully selected patients who desire symptom relief and preservation of erectile and ejaculatory function without the potential morbidity of more invasive procedures.

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“…To date there have been 12 studies published on Rezum, which have included 1391 patients (mean age 68.7 years, range: 46-90) (Tables 1 and 2). [9][10][11][12][13][14][15][16][17][18][19][20] Over half of these studies (n=7) have been published in the past 2 years, reflecting the increasing interest and uptake of this novel intervention. There has only been one randomized study and the remainder represent cohort studies (5x retrospective and 6 x prospective).…”

Section: Rezummentioning

confidence: 99%

Emerging Data on the Safety and Efficacy of Transurethral Water Vapour Therapy for Benign Prostatic Hyperplasia

Juliebø‐Jones¹,

Siena²,

Hameed³

et al. 2021

RRU

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Benign prostate disease is a disease of prevalence and over 25% of men affected by bothersome lower urinary tract symptoms (LUTS) as a result of it will require surgical intervention during their lifetime. While transurethral resection of the prostate (TURP) has served as the cornerstone treatment for many years, there now exist a multitude of minimally invasive alternatives including the Rezum system. The latter is a novel form of transurethral water vapour therapy, which is attracting increasing attention. It utilizes convective water vapour energy (WAVE) and thereby radiofrequency (RF) in order to generate heat energy. Early studies have demonstrated promising results. To date there have been 12 studies published on Rezum, however only one randomized trial. This review offers an overview and evaluation of this emerging evidence.

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Comparative Postoperative Outcomes of Rezūm Prostate Ablation in Patients with Large Versus Small Glands

Cited by 45 publications

References 13 publications

Rezum therapy for patients with large prostates (≥ 80 g): initial clinical experience and postoperative outcomes

Rezum therapy for patients with large prostates (≥ 80 g): initial clinical experience and postoperative outcomes

Reasons for new MIS. Let's be fair: iTIND, Urolift and Rezūm

Emerging Data on the Safety and Efficacy of Transurethral Water Vapour Therapy for Benign Prostatic Hyperplasia

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