Rezum therapy for management of frail patients with catheter dependent urinary retention due to benign prostate hyperplasia : A 1 year follow up study

Abstract

Purpose:

This study presents a 1-year follow-up for fragile patients with catheter-dependent urinary retention related to benign prostatic hyperplasia (BPH) treated with Rezum therapy.

Materials and methods:

All patients participating in this study exhibited catheter-dependent urine retention attributable to benign prostatic hyperplasia, with a mean prostate volume of 65 ± 13.1 ml. The study only included fragile patients with a PRISMA-7 questionnaire score of ⩾3. The study excluded patients with bladder or prostate cancer, ongoing urinary tract inflammation, a history of pelvic irradiation or prostate surgery, neurogenic bladder or urethral stricture. The treatment was carried out under local anesthesia, with the possibility of sedation. Patients were asked to follow up after 1, 2, 9, and 12 months of surgery. Clinical assessments included the IPSS score, bladder scans to determine pre- and post-voiding bladder volume, and an evaluation of the requirement for re-catheterization.

Results:

Eighty fragile patients with PRISMA-7 score ⩾3 underwent Rezum treatment for urinary retention due to BPH. Patients were monitored for 1 year after the procedure. Patients’ IPSS improved from 14 to 9.5 (p = 0.02), while post-void residual urine decreased from 50 mL to 12 mL (p < 0.001). Prostate volume reduced from 60.5 mL to 40.9 mL (p = 0.0003) and PSA levels also dropped, from 3.5 mg/dl to 2.3 ng/ml (p = 0.03).

Conclusion:

This study demonstrates that Rezum therapy is a feasible treatment option for frail patients with PRISMA-7 questionnaire score of ⩾3, presented with catheter dependent urinary retention. There were reported positive post-operative outcomes and an improvement in IPSS scores up to one year after surgery.