REZŪM WATER VAPOR THERMAL THERAPY IN THE TREATMENT OF BENIGN PROSTATIC HYPERPLASIA: CLINICAL OUTCOMES AND EFFICACY

Relevance. Benign prostatic hyperplasia is one of the most common urological conditions in elderly men, with both its prevalence and symptom severity increasing proportionally with age. At the same time, the effectiveness of conservative therapy is often limited, as many patients continue to experience significant lower urinary tract symptoms despite medical treatment. The standard surgical option — transurethral resection of the prostate— is associated with risks such as bleeding, hospitalization, and a high incidence of sexual dysfunction, with retrograde ejaculation occurring in 50–70% of patients. In this context, water vapor thermal therapy (Rezūm) represents a promising minimally invasive alternative. It provides durable relief of BPH-related symptoms with minimal invasiveness, allowing patients to avoid long-term pharmacotherapy and reduce the risk of surgical complications, while preserving the prostate gland and sexual function.

Aim. To evaluate the early clinical outcomes and safety of Rezūm water vapor thermal therapy in patients with benign prostatic hyperplasia.

Materials and Methods. A retrospective single-center analysis was conducted on the treatment outcomes of 9 men (aged 49–78 years; mean age 59.4 ± 9.1 years) presenting with severe lower urinary tract symptoms (IPSS ≥ 22) and moderate prostate enlargement (30.8–70.0 mL). All patients underwent Rezūm thermal ablation (4–6 vapor injections; mean procedure duration 7.8 ± 1.5 minutes). Follow-up at 3 months included assessment using the International Prostate Symptom Score, quality of life index related to symptoms, maximum urinary flow rate, post-void residual urine volume, prostate volume, and complication recording according to the Clavien–Dindo classification.

Results. By the 3-month follow-up, the total IPSS score had significantly decreased from 25.8 ± 2.9 to 5.9 ± 1.3 points (a 77% reduction; p < 0.01), and the QoL index improved from 5.0 ± 0.5 to 1.1 ± 0.3 (a 78% reduction; p < 0.01). Qmax increased from 6.6 ± 2.8 to 20.8 ± 2.8 mL/s (+215%; p < 0.01), while the PVR decreased from 128 ± 116 to 0 mL (p < 0.01). Prostate volume was reduced by 65% (from 53.3 ± 14.8 to 18.6 ± 2.9 mL; p < 0.01). Spontaneous voiding was restored in 100% of patients (median time: 7 days). Grade I–II complications were observed in 2 patients (11% macroscopic hematuria, 11% transient urinary retention). No complications of grade ≥ III, infections, or sexual dysfunctions were reported.

Conclusion. Rezūm water vapor thermal therapy provides a significant reduction in BPH-related symptoms, improves urodynamic parameters, and enables rapid recovery of spontaneous voiding with a minimal risk of complications. It may be considered an effective minimally invasive alternative to transurethral resection of the prostate.

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