The Efficacy of Rezum Water Vapor Therapy Among Malaysian Men with Lower Urinary Tract Symptoms Associated with Benign Prostatic Hyperplasia

Abstract

Purpose: This study investigates the efficacy and safety of Rezǔm water vapor in the management of Malaysian men with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH).
 Material and methods: A total of 60 men with symptoms of moderate to severe BPH were enrolled in pilot studies at Hospital Sultan Abdul Aziz Shah, Universiti Putra Malaysia. All patients were treated with transurethral delivery of water vapor. International Prostate Symptom Score (IPSS), quality of life (QoL), peak urinary flow (Qmax), postvoid residual, and International Index of Erectile Function (IIEF-5) were evaluated at 1 week and 1, 3, and 6 months post-treatment. Safety was also assessed.
 Results and discussion: The mean age of our study population was 64.57 ± 9.37 years old with mean prostate volume of 59.98 ± 22.06 cc. Our findings revealed statistically significant improvements throughout the 6 months of follow-up for IPSS score (17.45 ± 6.10 score to 7.53 ± 4.28), the QoL scores (3.52 ± 1.19 to 1.53 ± 0.70) and the urinary flow rate, Qmax (9.74 ± 3.39 mL/s to 17.40 ± 5.92 mL/s). There was no significant difference (p>0.05) was observed in sexual function (IIEF-5 scores) when compared to preoperatively. No adverse events (AEs) related to endoscopic instrumentations were observed. Two cases of urinary retention were classified as procedure-related AE.
 Conclusion: The Rezǔm water vapor therapy is safe and provides effective relief of symptoms and it should be considered as one of the treatment options in patients with LUTs associated with BPH especially for patients who are keen to preserve sexual function as part of the added benefit in this treatment modality.
 
 Keywords: Benign prostatic hyperplasia, lower urinary tract symptoms, water vapor therapy, minimally invasive