MP51-14 RE-TREATMENT FOR LOWER URINARY TRACT SYMPTOMS (LUTS) AFTER WATER VAPOR THERMAL THERAPY

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP51-14 RE-TREATMENT FOR LOWER URINARY TRACT SYMPTOMS (LUTS) AFTER WATER VAPOR THERMAL THERAPY Vi Nguyen, Michelle C. Leach, Clara Cerrato, Mimi V. Nguyen, and Seth K. Bechis Vi NguyenVi Nguyen More articles by this author , Michelle C. LeachMichelle C. Leach More articles by this author , Clara CerratoClara Cerrato More articles by this author , Mimi V. NguyenMimi V. Nguyen More articles by this author , and Seth K. BechisSeth K. Bechis More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003299.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Water vapor thermal therapy (Rezum, Boston Scientific, Marlborough, MA, USA) has become increasingly used as a minimally invasive surgical treatment for LUTS due to benign prostatic hyperplasia (BPH) with a low re-treatment rate. We sought to identify predictors of re-treatment or symptom recurrence. METHODS: We retrospectively reviewed patients treated with water vapor thermal therapy at a single institution from August 2017 to February 2022. Patient demographics, pre- and peri-operative data, and international prostate symptom scores (IPSS) were evaluated. Patients who underwent a second BPH procedure (“re-treatment”) for persistent or recurrent LUTS within 2 years of original treatment were compared to the remainder of the cohort who did not undergo re-treatment. Multivariate analysis (MVA) was used to assess for predictors of re-treatment. RESULTS: Data from 192 consecutive patients undergoing water vapor thermal therapy were collected and analyzed. 10 (5%) patients were re-treated. Men in the re-treatment cohort had smaller prostate volumes (48.5 vs 50.4, p=0.003) and received a greater number of water vapor injections (5 vs 4, p<0.001). Baseline IPSS score or median lobe treatment was not associated with re-treatment (Table 1a). At 6-month follow-up, total IPSS (10.13 vs 18.5, p=0.044) and IPSS voiding sub-scores (4.59 vs 9.5, p=0.006) were significantly worse in the re-treated group (Table 1b). On MVA, ≥3 total treatments (>1 per lobe) during an initial Rezum procedure were independently associated with increased risk of re-treatment (HR 8.51, p=0.039). Increasing prostate volume, catheter duration, and treatment of the median lobe were not significantly associated with an increased risk of re-treatment in these patients (Table 1c). CONCLUSIONS: We found that water vapor thermal therapy has a good performance with a low re-treatment rate, consistent with larger published studies. Men who did require re-treatment of their LUTS from BPH tended to receive more vapor injections and showed significant worsening of voiding symptom scores around 6 months post-operatively. Decreasing the number of vapor injections when possible may help further reduce treatment failure rates. 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 Vi Nguyen More articles by this author Michelle C. Leach More articles by this author Clara Cerrato More articles by this author Mimi V. Nguyen More articles by this author Seth K. Bechis More articles by this author Expand All Advertisement PDF downloadLoading ...