UP-65 Rezūm water vapor therapy for catheter-dependent urinary retention: Real-world Canadian experience
Thursday June 27, 2019 from
TBD
Presenter

Dean S. Elterman, Canada

Assistant Professor

Division of Urology

University Health Network, University of Toronto

Abstract

Rezūm water vapor therapy for catheter-dependent urinary retention: Real-world Canadian experience

Dean S. Elterman1, Naeem Bhojani2, Bilal Chughtai3, Kevin C. Zorn2.

1University Health Network, Toronto, ON, Canada; 2University of Montreal Hospital Center, Montreal, QC, Canada; 3Weill Cornell Medical College, New York, NY, United States

Introduction: Catheter-dependent urinary retention is typically treated with medical therapy, or failing that, transurethral surgery. Rezūm is a novel minimally invasive procedure using convective, water vapor to ablate benign prostatic tissue. Herein, we study the outcomes of treating catheter-dependent urinary retention with Rezūm.

Methods: Rezūm was introduced to Canada in 2019 as a novel, out-of-hospital, minimally-invasive surgical therapy for the treatment of BPH-LUTS.  A single, high-volume center prospectively collected baseline data including BPH history, uroflowmetry and validated questionnaires.  This was an analysis of patients with refractory, catheter-dependent urinary retention.

Results: 16 patients (mean age 68.7 years) with catheter-dependent urinary retention were treated with Rezūm from April 2019 to Dec 2020. The average prostate volume was 84.4ml (range 41-158ml) and 75% had a median lobe. All patients had at least one recent failed trial without catheter (TWOC) and 87.5% were on BPH oral medical therapy. The mean number of total injections of vapor was 14.5 (range 10-21). The mean duration of the procedure (scope in to scope out time) was 6.1 minutes (range 3.2-10.5). Visibility and bleeding during the procedure were assessed using a 5-points scale, and were rated as 1.4 and 1.3 respectively. Anesthesia was either IV propofol sedation (n=13) or Pethrox self-administered methoxyflurane inhaled medication (n=3). Mean catheter-duration until first planned TWOC was 28.4 days.  3 patients needed catheter replacement due to initial failed TWOC. At 1-month follow-up, 13/14 patients were spontaneously voiding and catheter-free. At 3-months, 14/14 patients were spontaneously voiding, and at 6-months, 15/15 patients were spontaneously voiding and catheter-free (1 patient was lost to follow-up).

Conclusions: Rezum water vapor therapy can successfully treat catheter-dependent urinary retention after initial failed TWOC in a quick, out-patient setting.


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