Rezum therapy may be effective for patients with large prostates: Study
According to the researchers from the Department of Urology, Icahn School of Medicine, New York, USA, it has been noted that in select large prostates patients, Rezum provided short-term symptomatic relief and improved voiding function comparable to small prostate patients, as published in the World Journal of Urology.Rezum is a minimally invasive surgery for benign prostatic...
According to the researchers from the Department of Urology, Icahn School of Medicine, New York, USA, it has been noted that in select large prostates patients, Rezum provided short-term symptomatic relief and improved voiding function comparable to small prostate patients, as published in the World Journal of Urology.
Rezum is a minimally invasive surgery for benign prostatic hyperplasia. Current guidelines recommend Rezum for prostates < 80 cc, but little data exist describing outcomes in patients with prostates ≥ 80 cc.
Hence, Evan B Garden and associates conducted this study to compare outcomes after Rezum therapy between men with small < 80 cc (SP) and large ≥ 80 cc prostates (LP).
The authors included patients undergoing Rezum, all of whom were subdivided by prostate volume (< 80, ≥ 80 cc). Outcomes were documented pre-and postoperatively. Descriptive analyses of urodynamics data (Qmax, PVR), symptom scores (AUA-SS, SHIM), disease management (medications, catheterization, retreatments), and clinical outcomes were conducted.
The findings were-
a. 36 (17.6%) men had prostates ≥ 80 cc (LP mean prostate size 106.8 cc).
b. LP men had improved Qmax and PVR postoperatively; those with longitudinal follow-up exhibited improved Qmax, PVR, and AUA-SS.
c. After one year, alpha-blocker usage decreased significantly (LP 94.44-61.11%, p = 0.001, SP 73.96-46.15%, p = 0.001); other medication usage and self-catheterization rates remained unchanged.
d. Compared to SP patients, differences in passing trial void (LP 94.44%, SP 93.45%), postoperative UTI (LP 19.44%, SP 10.12%), ED visits (LP 22.22%, SP 17.86%), readmissions (LP 8.33%, SP 4.76%), and retreatment (LP 8.33%, SP 4.76%) were insignificant.
e. However, mean days to foley removal (LP 9, SP 5.71, p = 0.003) and urosepsis rates (LP 5.56%, SP 0.00%, p = 0.002) differed.
Therefore, it was concluded that "in select LP patients, Rezum provided short-term symptomatic relief and improved voiding function comparable to SP patients. Postoperatively, though alpha-blocker usage decreased significantly, use of other medications did not change, and nearly two-thirds of patients still needed alpha-blockade. Further efforts should explore the possibility of expanding Rezum's inclusion criteria."
For further reference, log in to:
Garden EB, Shukla D, Ravivarapu KT, Kaplan SA, Reddy AK, Small AC, Palese MA. Rezum therapy for patients with large prostates (≥ 80 g): initial clinical experience and postoperative outcomes. World J Urol. 2021 Jan 3:1–8. doi: 10.1007/s00345-020-03548-7.
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