Early experience of primary transurethral water vapour treatment (Rezum®) for symptomatic benign prostatic hyperplasia: an analysis of 332 consecutive patients
BAUS ePoster online library. Shanmugathas N. 11/10/20; 304166; P8-7
Mr. Nimlan Shanmugathas
Mr. Nimlan Shanmugathas
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Early experience of primary transurethral water vapour treatment (Rezum®) for symptomatic benign prostatic hyperplasia: an analysis of 332 consecutive patients

Shanmugathas N1, Khoo C1, Connor M1, Eldred-Evans D1, Ho C1, Mahmood A1, Nokhodchi S1, Ting A1, Rai A1, Hosking-Jervis F1, Reddy D1, Tanaka M1, Shah T1, Rakauskas A1, Winkler M1, Agarwal S1, El-Husseiny T1, Ahmed H1
1Imperial College NHS Trust, London, United Kingdom

Introduction:
Transurethral water vapour treatment (Rezum®) is a novel minimally invasive therapy for lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). We report early functional outcomes and adverse events.

Methods:
Retrospective analysis of 332 consecutive patients at two centres between Aug/2017-Nov/2019. Inclusion criteria: LUTS secondary to BPH (pVol<120cc), acute urinary retention (passed TWOC), absence of clinically significant prostate cancer and no prior BPH treatment.

Results:
Median age was 69yrs (IQR 62-74) and median pVol 53cc (IQR 41-70) with 20.8% (69/332) >80cc. Pre-operatively, 66.9% (222/332) used α-blockers, with 42.7% (99/332) using 5α-reductase inhibitors. 99.0% (329/332) procedures were successfully completed. General anaesthesia, sedation and local anaesthetic were used in 81.3% (270/332), 18.4% (61/332) and 0.3% (1/332), respectively. Median operative duration was 9 minutes (IQR 7–12). There was successful 1st TWOC in 72.9% (242/332) a median 7 days post-operatively. 96.4% (320/332) achieved same-day discharge. Clavien-Dindo complications grade >/=2 occurred in 1.8% (6/332). 1.5% (5/332) were re-admitted for post-operative haematuria; none required blood product transfusion. In patients with paired outcomes, mean baseline IPSS was 22.7 (SD 6.6) and at 3-months 7.42 (SD 5.8) (change -15.3 (-67.4%)). Mean baseline QMax was 10.6 ml/s (SD 5.9) and at 3-months 17.4 ml/s (SD 8.1); (change +6.8 ml/s (+64.3%)). Further BPH surgery was performed for refractory symptoms in 1.8% (6/332).

Conclusion:
Early outcomes for primary Rezum® demonstrate low rates of serious adverse events and promising improvements in LUTS. Further prospective long-term and comparative evaluation will determine validity of these findings.
Early experience of primary transurethral water vapour treatment (Rezum®) for symptomatic benign prostatic hyperplasia: an analysis of 332 consecutive patients

Shanmugathas N1, Khoo C1, Connor M1, Eldred-Evans D1, Ho C1, Mahmood A1, Nokhodchi S1, Ting A1, Rai A1, Hosking-Jervis F1, Reddy D1, Tanaka M1, Shah T1, Rakauskas A1, Winkler M1, Agarwal S1, El-Husseiny T1, Ahmed H1
1Imperial College NHS Trust, London, United Kingdom

Introduction:
Transurethral water vapour treatment (Rezum®) is a novel minimally invasive therapy for lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). We report early functional outcomes and adverse events.

Methods:
Retrospective analysis of 332 consecutive patients at two centres between Aug/2017-Nov/2019. Inclusion criteria: LUTS secondary to BPH (pVol<120cc), acute urinary retention (passed TWOC), absence of clinically significant prostate cancer and no prior BPH treatment.

Results:
Median age was 69yrs (IQR 62-74) and median pVol 53cc (IQR 41-70) with 20.8% (69/332) >80cc. Pre-operatively, 66.9% (222/332) used α-blockers, with 42.7% (99/332) using 5α-reductase inhibitors. 99.0% (329/332) procedures were successfully completed. General anaesthesia, sedation and local anaesthetic were used in 81.3% (270/332), 18.4% (61/332) and 0.3% (1/332), respectively. Median operative duration was 9 minutes (IQR 7–12). There was successful 1st TWOC in 72.9% (242/332) a median 7 days post-operatively. 96.4% (320/332) achieved same-day discharge. Clavien-Dindo complications grade >/=2 occurred in 1.8% (6/332). 1.5% (5/332) were re-admitted for post-operative haematuria; none required blood product transfusion. In patients with paired outcomes, mean baseline IPSS was 22.7 (SD 6.6) and at 3-months 7.42 (SD 5.8) (change -15.3 (-67.4%)). Mean baseline QMax was 10.6 ml/s (SD 5.9) and at 3-months 17.4 ml/s (SD 8.1); (change +6.8 ml/s (+64.3%)). Further BPH surgery was performed for refractory symptoms in 1.8% (6/332).

Conclusion:
Early outcomes for primary Rezum® demonstrate low rates of serious adverse events and promising improvements in LUTS. Further prospective long-term and comparative evaluation will determine validity of these findings.
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