Mp51-12 "less is more" rezum: a propensity score matched comparison

You have accessJournal of UrologyCME1 Apr 2023MP51-12 "LESS IS MORE" REZUM: A PROPENSITY SCORE MATCHED COMPARISON Clara Cerrato, Mimi V. Nguyen, Dean Elterman, Kevin Zorn, Naeem Bhojani, Bilal Chughtai, and Seth K. Bechis Clara CerratoClara Cerrato More articles by this author , Mimi V. NguyenMimi V. Nguyen More articles by this author , Dean EltermanDean Elterman More articles by this author , Kevin ZornKevin Zorn More articles by this author , Naeem BhojaniNaeem Bhojani More articles by this author , Bilal ChughtaiBilal Chughtai More articles by this author , and Seth K. BechisSeth K. Bechis More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003299.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: We sought to evaluate the effect of a minimal approach of water vapor thermal therapy (Rezum), defined as 1 vapor treatment per prostate lobe, on postoperative outcomes and symptoms compared to patients who received multiple treatments per lobe. METHODS: We performed a multi-institutional retrospective review of patients who underwent Rezum procedure for symptomatic BPH from 2018 to 2022. Propensity score matching (PSM) was utilized to generate patient cohorts based on the number of treatments per lobe (1 per lobe including median lobe if present vs ≥2 per lobe) matched for age, BMI, and pre-operative prostate volume. Primary outcome of interest was post-operative complications and irritative symptoms. We then conducted a non-PSM independent T-test to analyze the differences in International Prostate Symptom Score (IPSS), QOL sub-score, and flow rates both before and after the procedure. Patients with existing urinary retention were excluded. RESULTS: 146 patients were included in the PSM with 73 patients in each arm. The ≥2 treatment group showed higher post-operative de-novo retention (p=0.009) and UTI (p=0.003) and had their median lobe more frequently treated (p=0.021) (Table 1a). On MVA, an increasing number of treatments (HR 1.3, p=0.039) and treatment of the median lobe (HR 4.7, p=0.008) were significant risk factors for post-procedure irritative symptoms (Table 1b). Mean IPSS and IPSS sub-scores were similar by 3 months up to 12 months after the procedure (Figure 1). At 6 months, patients treated with 1 injection per lobe showed comparable Qmax and voided volumes and better post-void residual volumes (Table 1d). CONCLUSIONS: Minimal Rezum treatment approach with a single water vapor injection per lobe, including median lobe, is a safe and effective option for patients undergoing treatment for BPH and is associated with improved postoperative complicationsand irritative voiding symptoms, and with comparable IPSS and flow outcomes. Further studies are needed to investigate the effect of this minimal approach on longer-term outcomes. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e697 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Clara Cerrato More articles by this author Mimi V. Nguyen More articles by this author Dean Elterman More articles by this author Kevin Zorn More articles by this author Naeem Bhojani More articles by this author Bilal Chughtai More articles by this author Seth K. Bechis More articles by this author Expand All Advertisement PDF downloadLoading ...