A single‑office experience of day‑case water vapor thermal therapy for benign prostatic hyperplasia

The present study aimed to clarify the feasibility, safety and efficacy of day‑case water vapor thermal therapy (WVTT) using the Rezum system in an office‑based setting. The present retrospective study included the data of 40 patients who underwent WVTT performed by a single surgeon at a single‑unit urology clinic from March, 2023 to January, 2024, including 11 patients with complete urinary retention. The present study analyzed the operation time and hospitalization time on the day of the procedure. The International Prostate Symptom Score‑Quality of Life (IPSS‑QOL), post‑void residual (PVR) volume, prostate volume (PV), medication use and adverse events (AEs) were monitored at baseline, and at 1, 2 and 3 months following treatment. All interventions were performed within a median period of 4.0 min (interquartile range (IQR), 2.0‑11.0). The mean hospitalization time on the day of the procedure was 274.8±53.8 (standard deviation) min. Furthermore, the patients exhibited significant improvements in their QOL based on their IPSS‑QOL scores. The PV and PVR volumes decreased significantly. Of the 40 patients, 39 (97.5%) voided spontaneously and were catheter‑free at a median period of 12.0 days (IQR, 6.0‑87.0) following the procedure. Benign prostatic hyperplasia medications were discontinued in 26 of the 40 (65%) patients. The median time to discontinuation was 58.0 days (IQR, 24.0‑114.0). A history of urinary retention and more than six injections during a procedure were found to increase the risk of prolonged post‑operative catheterization. Of the 40 patients, AEs were observed in 11 patients, including grade II gross hematuria in 2 patients (5%). On the whole, the present study demonstrated that day‑case WVTT is feasible, effective and safe as an office‑based, outpatient procedure.