Day case Rezum™ water vapour therapy for urinary retention secondary to benign prostatic hyperplasia

Objectives: Rezum (Boston Scientific) water vapour therapy is an effective day case minimally invasive surgical treatment (MIST) for men with troublesome lower urinary tract symptoms (LUTSs) due to benign prostatic obstruction. The potential place for MISTs in the treatment of patients with urinary retention or permanent catheter dependence is currently unclear. Patients and Methods: A total of 48 patients presenting with retention of urine (out of a total of 524 patients) over a 4-year period from 2017 underwent Rezum treatment. All patients were followed up at 3, 6 and 12 months after the procedure. At each visit, flow rate, post void residual urine, and patient reported outcome measures (PROMs) including International Prostate Symptom Score (IPSS) were recorded. Results: A total of 34 patients had an indwelling catheter prior to treatment and 14 were self-catheterising. The mean age was 67 years (standard deviation (SD) = 3) with a mean prostate volume of 56 mL (SD = 6). The average number of injections per case was 8 (SD1), which included median lobe (ML) treatment in one man. 75% of the patients passed their post treatment trial without catheter (TWOC). IPSS improved to 6 (p = 0.001) in 12 months. Conclusion: The results from this cohort of patients are encouraging. Further evaluation with longer follow-up is required. The addition of MISTs to the portfolio of options for men with retention of urine may offer a streamlined and efficient alternative to the conventional treatments, and help therefore to reduce the national waiting list, and allow men a more rapid solution avoiding prolonged catheterisation. Level of evidence: Not applicable.