The following is a summary of “Retreatment for Lower Urinary Tract Symptoms (LUTS) After Water Vapor Thermal Therapy,” published in the April 2024 issue of Urology by Nguyen et al.

This retrospective study aims to delineate predictors of retreatment for symptomatic recurrence among men undergoing water vapor thermal therapy (WVTT; Rezum, Boston Scientific, Marlborough, MA, USA), a minimally invasive surgical intervention for lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). Data were gleaned from 192 patients treated with WVTT at a single institution between August 2017 and February 2022. A subset of 10 patients (5%) underwent retreatment with a second BPH procedure for persistent or recurrent LUTS within 2 years of the initial treatment, constituting the retreatment cohort juxtaposed with the remainder who did not necessitate retreatment. Multivariate analysis was conducted to discern predictors of retreatment. 

The retreatment cohort exhibited smaller prostate volumes and received a greater number of water vapor injections compared to their counterparts. Notably, at the 6-month follow-up, the retreatment group manifested significantly worse total International Prostate Symptom Score (IPSS) and voiding sub-scores. Multivariate analysis revealed that receiving more than one treatment per lobe was independently associated with an elevated risk of retreatment. In conclusion, WVTT demonstrated a low retreatment rate, with key indicators of retreatment encompassing the number of injections administered and deteriorated voiding symptom scores at the 6-month mark postoperatively. Mitigating treatment failure rates may be achievable through the judicious reduction in the number of injections administered during WVTT procedures.

Source: sciencedirect.com/science/article/abs/pii/S0090429524002991