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Rezūm water vapor therapy in multimorbid patients with urinary retention and catheter dependency

Prostate Cancer and Prostatic Diseases volume 25, pages 302–305 (2022)Cite this article

Subjects

Abstract

Background

Water vapor thermal therapy (Rezūm) is a minimally invasive treatment for benign prostatic enlargement (BPE). We report on safety and efficacy of this method for treatment of recurrent urinary retention and relief of catheter dependency owing to BPE in multimorbid patients, considered unfit for surgery.

Methods

We retrospectively evaluated 136 patients with recurrent urinary retention who underwent water vapor therapy in an ambulatory setting with periprostatic block and optional sedation between 11/2017 and 02/2021 in three urological departments. The objective was successful catheter withdrawal and continuing catheter independency after 3- and 12-months following treatment.

Results

Mean patient age was 80.3 years (±7.8), mean prostate volume 54 ml (±27.3), and mean catheter dependency before treatment was 4.8 months (±6.0). ASA classification was a followed: II: 10%, III: 71%, and IV: 19%. All procedures were performed successfully in an ambulatory setting. Perioperative complications were infrequent and minor (Clavien-Dindo Grade 1–2) and included haematuria in 4.4% and urinary tract infection in 3.9% of all cases. A total of 103 patients (78.6%) were able to void spontaneously after a median of 31 days. No significant differences in age, prostate volume, duration of catheter dependency, vapor injections, and ASA score were found between patients with successful or unsuccessful outcome. The mean follow-up period was 6.1 months (±5.9, range 1–22 months). A 3-month follow-up was available for 77 patients (75%) and 34 patients (33%) were followed for 12 months. After 3 and 12 months, 93.5 and 91% of patients remained catheter independent. Fifteen patients (11%) died during follow-up, with a mean overall survival of 7.7 months (±4.7).

Conclusions

Water vapor therapy may prove to be a useful, minimally invasive treatment in a multimorbid population with catheter dependency after urinary retention, secondary to BPE, considered at highest risk or unfit for surgery. Future studies are warranted.

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Author information

Authors and Affiliations

  1. Department of Urology, Klinik Donaustadt, Vienna, Austria

    K. Eredics, C. Wehrberger, A. Henning, S. Sevcenco, M. Marszalek & M. Rauchenwald

  2. Department of Urology, Paracelsus Medical University, Salzburg, Austria

    S. Sevcenco, M. Horetzky, T. Kunit & L. Lusuardi

  3. Department of Urology, Klinik Favoriten, Vienna, Austria

    C. Falkensammer, U. Stoces & S. Madersbacher

  4. Department of Urology, Sigmund Freud Private University, Vienna, Austria

    S. Madersbacher

Authors
  1. K. Eredics
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  2. C. Wehrberger
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  10. M. Horetzky
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  11. T. Kunit
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  12. L. Lusuardi
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Contributions

EK: conception of study, data collection, data analysis and final interpretation, manuscript writing. WC: data collection, critical revision. HA: data collection. SS: data collection, critical revision. MM: critical revision. RM: conception of study, data collection. FC: data collection. SU: data collection. MS: critical revision, final approval. HM: data collection, data analysis. KT: data collection, critical revision. LL: critical revision, final approval.

Corresponding author

Correspondence to K. Eredics.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

Ethics approval was waived, and formal consent was not required, due to the retrospective nature of the study. All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Eredics, K., Wehrberger, C., Henning, A. et al. Rezūm water vapor therapy in multimorbid patients with urinary retention and catheter dependency. Prostate Cancer Prostatic Dis 25, 302–305 (2022). https://doi.org/10.1038/s41391-021-00462-w

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