Advertisement

What’s New in Rezum: a Transurethral Water Vapour Therapy for BPH

  • Zachary Green
  • Jennifer WestwoodEmail author
  • Bhaskar K. Somani
Benign Prostatic Hyperplasia (K McVary, Section Editor)
  • 17 Downloads
Part of the following topical collections:
  1. Topical Collection on Benign Prostatic Hyperplasia

Abstract

Purpose of Review

Rezum is a new minimally invasive treatment for benign prostate enlargement using thermal transurethral water vapour therapy. We review the evidence with advantages and disadvantages of this technique.

Recent Findings

There are five studies reported including a randomised control trial looking at the outcomes of Rezum. The outcomes show an IPSS reduction by 45–60%, QoL improvement with a score reduction of 37–59%, the Qmax improvement by 44–72% and the PVR reduction by 20–38%.

Summary

Convective water vapour therapy using the Rezum system has been shown to have successful outcomes in the treatment of LUTS resulting from BPH. The reported complications are infrequent and often minor, and it seems to be relatively cost-effective.

Keywords

Rezum Water vapour therapy BPH LUTS Minimally invasive therapy TURP 

Notes

Funding

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

Compliance with Ethical Standards

Conflict of Interest

Zachary Green and Jennifer Westwood each declare no potential conflicts of interest.

Bhaskar K. Somani is a section editor for Current Urology Reports.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Bin LK. Epidemiology of clinical benign prostatic hyperplasia. Asian J Urol. Elsevier Ltd. 2017;4(3):148–51.CrossRefGoogle Scholar
  2. 2.
    Abrams P, Cardozo L, Fall M, Griffiths D, Rosear P, Ulmsten U, et al. The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Neurourol Urodyn [Internet. 2002;178:167–78.CrossRefGoogle Scholar
  3. 3.
    Speakman M, Kirby R, Doyle S, Ioannou C. Burden of male lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) - focus on the UK. BJU Int. 2015;115:508–19.CrossRefGoogle Scholar
  4. 4.
    Barry MJ. Evaluation of symptoms and quality of life in men with benign prostatic hyperplasia. Urology. 2001;58(01):25–32.CrossRefGoogle Scholar
  5. 5.
    EAU Guidelines. Edn. Presented at the EAU Annual Congress Copenhagen. Arnhem: EAU Guidelines Office; 2018. https://uroweb.org/guidelines/compilations-of-all-guidelines. Accessed 3 March 2019.
  6. 6.
    Van AB, Barkin J, Elterman DS, Czerniak B, Dinney C, McConkey D, et al. Hyperplasia : a review. Curr Opin Oncol. 2014;23:863–910.Google Scholar
  7. 7.
    Foster HE, Barry MJ, Dahm P, Gandhi MC, Kaplan SA, Kohler TS, et al. Surgical management of lower urinary tract symptoms attributed to benign prostatic hyperplasia: AUA guideline. J Urol. 2018;Google Scholar
  8. 8.
    Jones P, Rajkumar GN, Rai BP, Aboumarzouk OM, Cleaveland P, Srirangam SJ, et al. Medium-term outcomes of Urolift (minimum 12 months follow-up): evidence from a systematic review. Urology. Elsevier Inc. 2016;97:20–4.CrossRefGoogle Scholar
  9. 9.
    Jones P, Rai BP, Nair R, Somani BK. Current status of prostate artery embolization for lower urinary tract symptoms: review of world literature. Urology. 2015:676–81.CrossRefGoogle Scholar
  10. 10.
    •• McVary KT, Rogers T, Roehrborn CG. Rezūm water vapor thermal therapy for lower urinary tract symptoms associated with benign prostatic hyperplasia: 4-year results from randomized controlled study. Urology [internet]. Elsevier Inc.; 2019;126:171–179. This paper outlines data collected in the only double blinded randomised control trial using Rezum. As of 2019 data are avialble for four years post implementation of the therapy. The study also features the largest number of participants. CrossRefGoogle Scholar
  11. 11.
    National Institute for Health and Care Excellence (NICE). Medtech innovation briefing (MIB158). Rezum for treating benign prostatic hyperplasia. London: NICE; 2018.Google Scholar
  12. 12.
    • Mynderse LA, Hanson D, Robb RA, Pacik D, Vit V, Varga G et al. Rezu¯m system water vapor treatment for lower urinary tract symptoms/benign prostatic hyperplasia: validation of convective thermal energy transfer and characterization with magnetic resonance imaging and 3-dimensional renderings. Urology. Elsevier Inc.; 2015;86(1):122–7. This paper provided objective data on the efficacy of Rezum and its viability for bringing about reduction in prostatic volume. CrossRefGoogle Scholar
  13. 13.
    Somani BK, Westwood J, Rai BP, Jones P, Geraghty R. Rezum: a new transurethral water vapour therapy for benign prostatic hyperplasia. Ther Adv Urol. 2018;10:327–33.CrossRefGoogle Scholar
  14. 14.
    Gittelman MC, Gange SN, Patel K, Roehrborn CG, Beahrs JR, Levin RM, et al. Convective thermal therapy: durable 2-year results of randomized controlled and prospective crossover studies for treatment of lower urinary tract symptoms due to benign prostatic hyperplasia. J Urol Elsevier Ltd. 2016;197(6):1507–16.PubMedGoogle Scholar
  15. 15.
    Dixon C, Cedano ER, Pacik D, Vit V, Varga G, Wagrell L, et al. Efficacy and safety of Rezūm system water vapor treatment for lower urinary tract symptoms secondary to benign prostatic hyperplasia. Urology. Elsevier Inc. 2015;86(5):1042–7.CrossRefGoogle Scholar
  16. 16.
    Dixon CM, Cedano ER, Pacik D, Vit V, Varga G, Wagrell L, et al. Two-year results after convective radiofrequency water vapor thermal therapy of symptomatic benign prostatic hyperplasia. Res Rep Urol. 2016;8:207–16.PubMedPubMedCentralGoogle Scholar
  17. 17.
    Shore ND, McVary KT, Roehrborn CG, Kaminetsky J, Dixon CM, Cantrill CH, et al. Minimally invasive prostate convective water vapor energy ablation: a multicenter, randomized, controlled study for the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia. J Urol Elsevier Ltd. 2015;195(5):1529–38.PubMedGoogle Scholar
  18. 18.
    Roehrborn CG, Gange SN, Gittelman MC, Goldberg KA, Patel K, Shore ND, et al. Convective thermal therapy: durable 2-year results of randomized controlled and prospective crossover studies for treatment of lower urinary tract symptoms due to benign prostatic hyperplasia. J Urol. 2017;197:1507–16.CrossRefGoogle Scholar
  19. 19.
    Darson MF, Alexander EE, Schiffman ZJ, Lewitton M, Light RA, Sutton MA, et al. Procedural techniques and multicenter postmarket experience using minimally invasive convective radiofrequency thermal therapy with Rezūm system for treatment of lower urinary tract symptoms due to benign prostatic hyperplasia. Res Rep Urol. 2017;9:159–68.PubMedPubMedCentralGoogle Scholar
  20. 20.
    Mollengarden D, Goldberg K, Wong D, Roehrborn C. Convective radiofrequency water vapor thermal therapy for benign prostatic hyperplasia: a single office experience. Prostate Cancer Prostatic Dis Springer US. 2018;21:379–85.CrossRefGoogle Scholar
  21. 21.
    Gupta N, Rogers T, Holland B, Helo S, Dynda D, McVary KT. Three-year treatment outcomes of water vapor thermal therapy compared to doxazosin, finasteride and combination drug therapy in men with benign prostatic hyperplasia: cohort data from the MTOPS trial. J Urol [Internet] Elsevier Ltd. 2018;200(2):405–13.CrossRefGoogle Scholar
  22. 22.
    McVary KT, Gange SN, Gittelman MC, Goldberg KA, Patel K, Shore ND, et al. Erectile and ejaculatory function preserved with convective water vapor energy treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia: randomized controlled study. J Sex Med [Internet] Elsevier. 2016;13(6):924–33.CrossRefGoogle Scholar
  23. 23.
    McVary KT, Rogers T, Mahon J, Gupta NK. Is sexual function better preserved after water vapor thermal therapy or medical therapy for lower urinary tract symptoms due to benign prostatic hyperplasia? J Sex Med. 2018;15:1728–38.CrossRefGoogle Scholar
  24. 24.
    • Ulchaker J, Martinson M. Analyzing the Cost-Effectiveness of Six Therapies for Treating Lower Urinary Tract Symptoms Due To Benign Prostatic Hyperplasia. J Urol. 2018;199:29–43 In-depth analysis of the costs associated with new minimally invasive prosate therapies. Highlights potential for implementation within various health services.CrossRefGoogle Scholar
  25. 25.
    Otto B, et al. Incidental prostate cancer in transurethral resection of the prostate specimens in the modern era. Advances Urol. 2014;2014:627290.  https://doi.org/10.1155/2014/627290.CrossRefGoogle Scholar
  26. 26.
    Abedi AR, Fallah-Karkan M, Allameh F, Ranjbar A, Shadmehr A. Incidental prostate cancer: a 10-year review of a tertiary center, Tehran, Iran. Res Rep Urol. 2018;10:1–6.PubMedPubMedCentralGoogle Scholar
  27. 27.
    McVary KT, Roehrborn CG. Three-year outcomes of the prospective, randomized controlled Rezūm system study: convective radiofrequency thermal therapy for treatment of lower urinary tract symptoms due to benign prostatic hyperplasia. Urology Elsevier Inc. 2018;111:1–9.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Zachary Green
    • 1
  • Jennifer Westwood
    • 1
    Email author
  • Bhaskar K. Somani
    • 1
    • 2
  1. 1.University Hospital Southampton NHS TrustSouthamptonUK
  2. 2.South Coast Urology (SCU)SouthamptonUK

Personalised recommendations