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

Dean S. Elterman, Canada

Assistant Professor

Division of Urology

University Health Network, University of Toronto


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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