INTRODUCTION

Rezum water vapour therapy is a minimally invasive treatment for symptomatic BPH. The surgical treatment options for men with larger prostate glands are rather limited, and invariably involve a significant in-patient stay.

Methods

This study involves a prospective analysis of data for men undergoing Rezum comparing pre-treatment assessments with 3 months follow-up data. Gland volumes in the cohort ranged from between 20 and 120ml. We compared men with glands <80mls and >80mls. Pre and post procedure assessments included validated questionnaires (IPSS with QoL, IIEF-5), urinary flow rate (Qmax), prostate volume and length of stay. 125 patients were included of whom 19 had gland volumes >80 mls.

Results
The mean IPSS before and 3 months after treatment for the cohort was 22.0 and 5.6 respectively (22.6 for small glands and 21.0 for large glands pre, p=0.44 and 5.6 vs. 5.7 post, p=0.89). The QoL scores in small and large glands were 4.4 and 4.3, p=0.83 pre-treatment and 1.4 vs. 1.0 post, p=0.44. There were no significant differences in flow rate or length of stay. A single patient in each group required bladder washout in theatre due to secondary haemorrhage. 6 patients in the small gland group were treated for UTI compared to 1 in the large gland group.

CONCLUSION

In this series there was no significant overall difference in early post treatment outcomes when comparing both groups. Further studies are necessary to determine a sensible 'upper limit' in gland size for those wishing to consider this new therapy.