MP01-09 RISK FACTORS FOR A DELAYED IMPROVEMENT IN LOWER URINARY TRACT SYMPTOMS FOLLOWING CONVECTIVE WATER VAPOR THERMAL THERAPY

Abstract

You have accessJournal of UrologyCME1 May 2022MP01-09 RISK FACTORS FOR A DELAYED IMPROVEMENT IN LOWER URINARY TRACT SYMPTOMS FOLLOWING CONVECTIVE WATER VAPOR THERMAL THERAPY Sarang Janakiraman, Michael Felice, Aya Bsatee, Gaurav Pahouja, and Kevin T. McVary Sarang JanakiramanSarang Janakiraman More articles by this author , Michael FeliceMichael Felice More articles by this author , Aya BsateeAya Bsatee More articles by this author , Gaurav PahoujaGaurav Pahouja More articles by this author , and Kevin T. McVaryKevin T. McVary More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002513.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Convective water vapor thermal therapy (CWVTT) is a minimally invasive surgical therapy (MIST) for LUTS/BPH that has been shown to produce clinically significant results up to 5 years. We aimed to identify the incidence and risk factors for delayed improvement in LUTS and retreatment following CWVTT in men with LUTS/BPH. METHODS: Patients who underwent CWVTT from 1/2018 to 12/2020, at a single institution, were identified by CPT code. Pertinent patient, treatment, and outcomes data were extracted. Pressure flow studies were done in 73% of eligible patients. Patients missing pre- or immediate post- operative International Prostate Symptom Score (IPSS) were excluded. Delayed LUTS improvement was defined as failure to reach a minimally important clinical difference (MCID) of 25% on the IPSS after 4 weeks following CWVTT. Potential risk factors of delayed LUTS improvement were assessed by logistic regression. RESULTS: 109 patients were qualified for analysis. 50% of patients experienced delayed LUTS improvement (failure to reach MCID at 4 weeks), although, 82% of men reached the MCID by 12 months. Time from CWVTT, bladder outlet obstruction index (BOOI), and prior surgical BPH therapy were associated with delayed LUTS improvement on multivariate logistic regression. For each additional month following CWVTT, the odds of achieving MCID in LUTS increases by 9% (OR=0.91, 95% CI 0.86-0.97, p=.003). Every 10-unit increase in BOOI was associated with a 15% chance increase in achieving MCID in LUTS at 4 weeks following CWVTT (OR=0.85, 95% CI 0.75-0.96 , p=.01). Patients receiving prior surgical BPH therapy were 3.5 times more likely to experience a delayed improvement in LUTS (OR=3.47, 95% CI 1.36-8.90, p=.01). CONCLUSIONS: 50% of men undergoing CWVTT experienced delayed LUTS improvement (failure to reach MCID at 4 weeks). The odds of reaching a MCID increases by 9% with each subsequent month. Men with a high BOOI indicative of more severe obstruction are more likely to reach the MCID. Men with failed prior BPH surgery are at risk of failing to reach MCID. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e4 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sarang Janakiraman More articles by this author Michael Felice More articles by this author Aya Bsatee More articles by this author Gaurav Pahouja More articles by this author Kevin T. McVary More articles by this author Expand All Advertisement PDF DownloadLoading ...