MP51-13 FOUR-YEAR REZUM OUTCOMES IN RELATIONSHIP TO THE NUMBER OF INJECTIONS: IS THE “LESS IS MORE” TREATMENT APPROACH DURABLE?

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You have accessJournal of UrologyCME1 Apr 2023MP51-13 FOUR-YEAR REZUM OUTCOMES IN RELATIONSHIP TO THE NUMBER OF INJECTIONS: IS THE “LESS IS MORE” TREATMENT APPROACH DURABLE? Mustufa Babar, Umair Azhar, Justin Loloi, Rahman Sayed, Kevin Labagnara, Michael Zhu, Kevin Tang, Azizou Salami, Sandeep Singh, Matthew Ines, Nazifa Iqbal, and Michael Ciatto Mustufa BabarMustufa Babar More articles by this author , Umair AzharUmair Azhar More articles by this author , Justin LoloiJustin Loloi More articles by this author , Rahman SayedRahman Sayed More articles by this author , Kevin LabagnaraKevin Labagnara More articles by this author , Michael ZhuMichael Zhu More articles by this author , Kevin TangKevin Tang More articles by this author , Azizou SalamiAzizou Salami More articles by this author , Sandeep SinghSandeep Singh More articles by this author , Matthew InesMatthew Ines More articles by this author , Nazifa IqbalNazifa Iqbal More articles by this author , and Michael CiattoMichael Ciatto More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003299.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Traditional treatment approach for Rezum utilizes injections based on prostate volume. Recent literature with short-term follow-up has shown that improvements in lower urinary tract symptoms (LUTS) can be achieved with less injections. We assessed the long-term durability of Rezum outcomes in relationship to the number of injections utilized during treatment. METHODS: A single office, retrospective study was conducted on men with moderate to severe LUTS who were treated with Rezum. Men were stratified into four cohorts based on the number of injections received per lateral prostatic lobe: 1, 2, 3, or 4 injections. International Prostate Symptom Score (IPSS), quality of life (QoL), maximum urinary flow rate (Qmax), postvoid residual (PVR), and adverse events (AEs) were collected at baseline, 1-, 3-, 6-, 12- and/or 48-months postoperatively. The impact of the number of injections on urinary outcomes and AEs were assessed using multivariate linear regression and logistic regression models, respectively, after adjusting for confounders at baseline. RESULTS: A total of 179 men were included: 58, 91, 22, and 8 men in the 1, 2, 3, and 4 injections cohorts, respectively. Compared to baseline, at 3-months, all cohorts saw significant mean changes in IPSS (-9.7±7.9, p<0.001) and QoL (-1.9±1.9, p<0.001), and improvements remained durable to 48-months (IPSS -10.8±9.0, p<0.001; QoL -2.7±1.9, p<0.001). The 2 injections cohort saw a significantly greater mean change in Qmax at 6-months (10.2±10.1 ml/s) when compared to the 1 injection cohort (0.6±4.6 ml/s, p=0.02). There were no significant differences in mean changes in IPSS, QoL, and PVR between the cohorts at any follow-up (p>0.05). The most common AE was gross hematuria (69.8%), followed by penile burning (65.8%). By 48-months, reoperation rate was 9.2%, with no significant difference in reoperation rates between the cohorts (p>0.05). Multivariate logistic regression showed that for each additional injection, the odds of gross hematuria, penile burning, penile pain, and dysuria increased by 3.8 (95% CI 1.7, 9.1), 2.6 (95% CI 1.2, 5.9), 2.2 (95% CI 1.1, 4.9), and 3.0 (95% CI 1.3, 7.5), respectively. Multivariate linear regression showed that the number of injections was not significantly associated with changes in IPSS, QoL, and PVR at any follow-up (p>0.05) but significantly associated with change in Qmax at 3-months (β=5.7, p=0.02). CONCLUSIONS: Utilizing less lateral lobe injections during Rezum treatment is a safer treatment approach that can still achieve long-term durable relief in LUTS. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e698 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mustufa Babar More articles by this author Umair Azhar More articles by this author Justin Loloi More articles by this author Rahman Sayed More articles by this author Kevin Labagnara More articles by this author Michael Zhu More articles by this author Kevin Tang More articles by this author Azizou Salami More articles by this author Sandeep Singh More articles by this author Matthew Ines More articles by this author Nazifa Iqbal More articles by this author Michael Ciatto More articles by this author Expand All Advertisement PDF downloadLoading ...