MP09-05 REZUM FOR MEN WITH LARGE PROSTATES ≥80 cc VERSUS SMALL PROSTATES <80 cc: UPDATED OUTCOMES AND LONG-TERM RESULTS

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology II (MP09)1 Sep 2021MP09-05 REZUM FOR MEN WITH LARGE PROSTATES ≥80 cc VERSUS SMALL PROSTATES <80 cc: UPDATED OUTCOMES AND LONG-TERM RESULTS Evan Garden, Krishna Ravivarapu, Micah Levy, Olamide Omidele, Devki Shukla, Osama Al-Alao, Norman Coleburn, Mantu Gupta, Craig Nobert, Susan Marshall, Jay Motola, Avinash Reddy, Robert Valenzuela, Steven Kaplan, Alexander Small, and Michael Palese Evan GardenEvan Garden More articles by this author , Krishna RavivarapuKrishna Ravivarapu More articles by this author , Micah LevyMicah Levy More articles by this author , Olamide OmideleOlamide Omidele More articles by this author , Devki ShuklaDevki Shukla More articles by this author , Osama Al-AlaoOsama Al-Alao More articles by this author , Norman ColeburnNorman Coleburn More articles by this author , Mantu GuptaMantu Gupta More articles by this author , Craig NobertCraig Nobert More articles by this author , Susan MarshallSusan Marshall More articles by this author , Jay MotolaJay Motola More articles by this author , Avinash ReddyAvinash Reddy More articles by this author , Robert ValenzuelaRobert Valenzuela More articles by this author , Steven KaplanSteven Kaplan More articles by this author , Alexander SmallAlexander Small More articles by this author , and Michael PaleseMichael Palese More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001982.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prior studies described preliminary safety and efficacy of Rezum water vapor thermal therapy for treatment of benign prostatic hyperplasia (BPH) for men with large prostates >80 cc (LP). Here, we offer updated LP outcomes compared to men with small prostates <80 cc (SP). METHODS: 375 men underwent Rezum at an academic institution between 1/2017-1/2021. Those with partial treatments or follow up <30 days were excluded. Pre- and postoperative data were collected for prostate size, serum PSA, AUA symptom score (AUA-SS), Qmax, PVR, BPH medications up to 1 year postoperatively, catheter dependence, trial of void (TOV) success, surgical retreatments, complications, ER visits, and readmissions. Descriptive and comparative analyses were conducted between groups. RESULTS: 73.9% (277/375) of patients met criteria, including 83.1% LP (49/59) and 72.2% SP (228/316). LP received more total Rezum injections (median LP 8 [IQR 6, 11.5] vs SP 5 [IQR 3, 6], p <0.01) and had longer follow up (mean LP 441.9 + 384.4 vs SP 309.6 + 326.1, p=0.045). After Rezum, LP had improved Qmax (mean 6.3 + 4.6 to 11.1 + 9.6, p=0.016) and PVR (mean 160.6 + 150.9 to 78.7 + 108.3, p <0.01); changes in AUA-SS were not significant (mean 15.8 + 6.1 to 12.4 + 8.6, p=0.164). SP had significantly improved Qmax, PVR, and AUA-SS (all p <0.05). Neither group saw significant changes in prostate size postoperatively. Outcomes are summarized in table 1. Both groups had decreased alpha-blocker usage after Rezum (LP 83.8% to 49.0%, SP 70.2% to 43.4%, both p <0.01). There were no changes in 5-ARI, antispasmodic, or PDE-5 inhibitor usage in LP. LP had catheters for longer before TOV (median LP 6 days [IQR 4, 9] vs SP 5 days [IQR 3, 6], p <0.01). Initial TOV success did not differ, though LP were more likely to require catheterization within 90-days of procedure (LP 20.4% vs SP 9.2%, p=0.024). LP required surgical retreatment more often (LP 18.4% vs SP 5.7%, p=0.011) after a median of 520 days (IQR 210, 953). Rates of minor complications, UTI, ER visits, and readmissions did not differ between groups (all p >0.05). CONCLUSIONS: Rezum for LP provided relief of BPH symptoms and improved urinary function without elevated risk of most major complications compared to SP. Postoperatively, LP experienced longer catheterization, higher chance of catheter dependence, and more retreatment. Source of Funding: N/A © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e161-e161 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Evan Garden More articles by this author Krishna Ravivarapu More articles by this author Micah Levy More articles by this author Olamide Omidele More articles by this author Devki Shukla More articles by this author Osama Al-Alao More articles by this author Norman Coleburn More articles by this author Mantu Gupta More articles by this author Craig Nobert More articles by this author Susan Marshall More articles by this author Jay Motola More articles by this author Avinash Reddy More articles by this author Robert Valenzuela More articles by this author Steven Kaplan More articles by this author Alexander Small More articles by this author Michael Palese More articles by this author Expand All Advertisement Loading ...