Convective Radio Frequency Thermal Therapy for Treatment of Benign Prostatic Hyperplasia: Single Office Experience with 255 Patients over 4 Years.

Abstract

Convective radio frequency thermal therapy with the Rezūm® system is a relatively new treatment for benign prostatic hyperplasia with proven short-term durability. We report an update of previously published data from a single center showing durability through 4 years. A retrospective review of 255 patients who underwent the Rezūm procedure from a single surgeon was performed, including 25 patients from the Rezūm II study, from March 2014 to April 2018. Maximum urinary flow rate, I-PSS (International Prostate Symptom Score), I-PSS-QOL (quality of life), post-void residual, medication use and adverse events were monitored. Data were analyzed at baseline, and 3, 6, 12, 24, 36 and 48 months after treatment. Statistically significant improvement in maximum urinary flow rate (57.2%), I-PSS (54.7%) and I-PSS-QOL (59.2%) appear to be durable through 48 months, with improvement greater than 50% at most recent followup. We report a similarly low reoperation rate compared to the most recent data from the Rezūm II study (3.1% vs 4.4%), but with higher rates of urinary tract infection (18.8% vs 3.7%) and urinary retention (15.7% vs 3.7%). Overall satisfaction with the procedure experience (93.9%) and the outcome (90.9%) was high, with 97% of men interviewed recommending the procedure to a friend. In addition, 80% of men were able to stop all medication. Our experience provides the largest published cohort of patients undergoing this procedure and shows durable improvements in maximum urinary flow rate, I-PSS and I-PSS-QOL through 4 years. Patients outside of the inclusion criteria of Rezūm II appear to benefit from the procedure.