Our experiences with Rezˉum water vapor therapy
DOI: 10.2259/magyurol.2024.3.hadia.143
Authors:
Ali Hádi dr., Ali Tarek dr.
Szabolcs-Szatmár-Bereg Vármegyei Oktatókórház Jósa András Tagkórház, Urológia Osztály,
Nyíregyháza (osztályvezető: Adányi József dr.)
Summary
Introduction: Most elderly Hungarian male suffer the symptoms of benign prostate hyperplasia, such as weak urination stream and nocturia. In most cases it can be treated with medication, but if the postvoided residual volume is increasing it can cause upper urinary dilatation, infections even bladder stone. In these cases, surgical treatment is needed. Nowadays, the gold-standard procedure to treat benign prostate hyperplasia in Hungary, is monopolar transurethral prostate resection. The most feared complications are incontinence and erectile dysfunction, retrograde ejaculation. There are several alternative surgical options which can improve urination, with less side effect. These alternative treatments, for example bipolar/laser enucleation and water vapor thermal therapy.
Materials and methods: During the study there were 18 Rezuˉm procedures. The average age was 67 years, 77% of the patients had catheter, and the average prostate size was 83 ml. All the patients were on pharmacological management, 60% of them were on combination therapy.
Result: There were an average 12 injections, the operation time took about 25 minutes. In most cases we did the procedure under local or spinal anesthesia. We managed to do the operation on numerous patients who were not allowed for other procedures. After the operation 6 patients had to keep the catheter for more than 1 month, but on the next follow-up nobody had a catheter. On the 12-month follow-up only one person needed a catheter. Among the sexually active patients, nobody had any side effects after the procedure.
Conclusion: Rezuˉm is an efficient, rapid and safe method. We managed to achieve remarkable result not only for patients with small prostate, but also for those who had large prostate, big median lobe or had a catheter. It can be safely performing in cases where preservation of erectile function and continence are primary, and even where no other procedures can be performed.