Prostatic hyperplasia patients for several years of "male" words, 10 minutes can be solved? Results of a multicenter study of the minimally invasive therapy Rezum announced

Yimaitong compiles and arranges, please do not reprint
without authorization.

Guide

The incidence of lower urinary tract symptoms (LUTS) caused by benign prostatic obstruction (BPO) increases with age, plagues many middle-aged and elderly men
.
As common treatment options for benign prostatic hyperplasia (BPH), drugs and surgery still have some shortcomings, such as difficulty in preserving the sexual function of patients, high incidence of surgery-related complications, and poor drug compliance
.

Recently, an article published by Prostate Cancer Prostatic Dis announced the urinary and sexual function outcomes of BPH patients after minimally invasive therapy Rezum.

Research background

The Rezum system is one of the latest minimally invasive surgical treatments for BPH, but data on urinary and sexual outcomes and complications are lacking
.
This review reviewed Italian multicentre case data from June 2019 to April 2021 to assess urinary and sexual function outcomes
for Rezum.

Study design

The study included all patients
with BPO with moderate to severe LUTS who were treated with Rezum at seven Italian medical centres.
Exclusion criteria were age <18 years, prior history of BPO intervention, mild international prostate symptom score (IPSS), maximum urine flow rate (Qmax) >15 mL/s, prostate volume < 30 and > 120 cc, residual urine volume (PVR) >250 ml
。 The investigators defined the ideal voiding function as an IPSS score of <7 or 50% improvement ≥ (from baseline), a peak flow rate improvement of ≥50% and/or >15 mL/s, a quality of life questionnaire score of ≥1 point, and no major complications
such as acute urinary retention (AUR), blood transfusion, or urinary incontinence during the perioperative period.
Ideal sexual function is defined as maintaining anterograde ejaculation or no change in ejaculatory function after surgery (most recent follow-up) and an increase or stabilization or decrease in the International Erectile Function Index (IIEF-5) score by ≤1 grade
.

Study results

A total of 262 patients were included in the study with a median follow-up of 11 (IQR 5 to 15) months
.
The median operative time from instrument transurethral insertion to patient catheterization was 11 (IQR 9-15) minutes, and most patients (62.
5%) were discharged within a few hours of surgery without serious complications
of Clavien-Dindo graded III or IV in early (within 30 days postoperative) or late (after 90 days postoperatively).
Early complications occurred in 39.
3% of patients, with 4 (1.
5%) patients having clot retention and 1 (0.
39%) requiring blood
transfusion.
Urge incontinence occurred in 6 (2.
2%) patients, and 4 (1.
5%) patients failed treatment and required reoperation
.

Table 1 Early and late complications

Desired voiding function and sexual function outcomes
were achieved in 52.
9% and 87.
8% of patients, respectively.
Thirty-eight patients with preoperative indwelling catheters did not require indwelling catheterization after Rezum, 70% had IPSS scores < 7 points or ≥50% improvement from baseline, 70.
2% had peak flow rate improvement of ≥50% and/or >15 mL/s, and 92.
7% had a quality of life questionnaire score of ≥1 point
.
The anterograde ejaculation rate of Rezum patients before surgery was 56.
5%, which increased to 78.
2% postoperatively, an increase of 21.
7%.

Ejaculatory function was preserved
in 96.
6% of patients.
By the end of follow-up, there were no newly diagnosed cases
of erectile dysfunction.

Table 2 Changes in functional parameters after Rezum

Conclusion of the study

In conclusion, Rezum is a safe and well-tolerated minimally invasive surgical modality that is beneficial to improve urinary function and preserve sexual function
in patients with BPH.

References:

Campobasso D, Siena G, Chiodini P, et al.
Composite urinary and sexual outcomes after Rezum: an analysis of predictive factors from an Italian multi-centric study.
Prostate Cancer Prostatic Dis.
2022 Aug 30.