Expert Guidelines on Rezūm™: Safe Prostate Treatment with Minimal Sexual Side Effects

What is it about?

This research presents a systematic review and expert consensus on water vapour thermal therapy (WVTT), Rezüm™, as a minimally invasive surgical technique for treating benign prostatic hyperplasia (BPH) with lower urinary tract symptoms (LUTS). The methodology involved a comprehensive literature search in PubMed without date restrictions, leading to the analysis of 49 relevant articles, complemented by discussions with a panel of five urology experts. The scope of This study includes defining recommendations for the execution of WVTT and identifying the ideal patient profile for this intervention. Main findings suggest that WVTT is suitable for patients with moderate to severe symptoms, no age restriction, a Qmax of less than 15 mL/s, and prostate volumes greater than 30 cm³. The therapy is noted for its low retreatment rate and minimal impact on sexual functions, making it a potential first-line treatment option. However, This research highlights the need for further research in areas such as postoperative care, anaesthesia, and antibiotic prophylaxis. This study positions WVTT as a viable alternative to traditional treatments, reflecting its growing adoption in clinical practice.

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Why is it important?

This review examines the evolving landscape of treatments for benign prostatic hyperplasia (BPH), focusing on water vapour thermal therapy (WVTT) as a minimally invasive surgical option. The review is significant as it compiles and synthesizes existing literature and expert opinions to establish guidelines for the appropriate use of WVTT, a technique gaining recognition for its ability to alleviate symptoms while preserving sexual function. Understanding the ideal patient profile and execution of this therapy can aid in optimizing clinical outcomes and potentially widen its adoption in urological practice. Key Takeaways: 1. This review summarises that WVTT is a viable option for patients with moderate to severe lower urinary tract symptoms associated with BPH, especially noting its low retreatment rate and preservation of sexual function. 2. The review addresses the ideal patient profile for WVTT, highlighting suitability for individuals with a prostate volume greater than 30 cm³, no age restrictions, and a Qmax of less than 15 mL/s. 3. The review identifies areas requiring further research, such as postoperative care, anaesthesia, and antibiotic prophylaxis, to enhance understanding and implementation of WVTT in clinical settings.