Safety and efficacy of WVTT (Rezum) in young men: preliminary data

Objectives Water vapor thermal therapy (WVTT) is one of the latest developed minimally invasive surgical treatments (MIST) for benign prostatic hyperplasia-related symptoms (LUTS/BPH). We focused on the functional outcomes of patients < 50 years treated with Rezum for BPH. Methods We prospectively recorded data on patients treated with Rezum at 5 institutions from April 2020 to June 2021. Uroflowmetry, prostatic specific antigen (PSA), ultrasonography assessing prostate volume and post voiding residual volume (PVR), the International Prostate Symptom Score (IPSS), International Index of Erectile Function (IIEF-5), and the question yes/no assessing ejaculatory dysfunction were recorded at baseline, and 3, 6 and 12 months later. Results Ten patients were enrolled. The median operative time was 9 (IQR 8.25-13) min. All patients were dismissed a few hours after surgery with an indwelling urinary catheter that was removed after a median of 7 days (IQR 7-7). Each patient experienced an improvement both in terms of IPSS domain and in terms of maximal flow (Qmax) and PVR with a significative difference from the baseline observed at 3 months, stable until the last follow-up. Everyone maintained or gained antegrade ejaculation. No major post-operative complications were recorded, as just one patients experienced acute urinary retention after catheter removal. Conclusions WVTT treatment is a feasible and safe minimally invasive option for patients < 50 y old with LUTS/BPH and showed optimal early functional outcomes.