MP27-16 FAILED TRIAL WITHOUT CATHETER POST REZūm IN NON-CATHETER DEPENDENT PATIENTS: RISK FACTORS FROM THE CANADIAN REZūm REGISTRY

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology II (MP27)1 May 2024MP27-16 FAILED TRIAL WITHOUT CATHETER POST REZūm IN NON-CATHETER DEPENDENT PATIENTS: RISK FACTORS FROM THE CANADIAN REZūm REGISTRY Roseanne Ferreira, Naeem Bhojani, Bilal Chughtai, Kevin C. Zorn, and Dean Elterman Roseanne FerreiraRoseanne Ferreira , Naeem BhojaniNaeem Bhojani , Bilal ChughtaiBilal Chughtai , Kevin C. ZornKevin C. Zorn , and Dean EltermanDean Elterman View All Author Informationhttps://doi.org/10.1097/01.JU.0001009400.86696.a2.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Rezūm has become an increasingly popular surgical approach for treating bladder outlet obstruction. Despite the practice of routinely placing a Foley catheter for a median of 3-4 days post-procedure, TWOC (Trial Without Catheter) failure remains variable and disconcerting for patients and providers alike. This study seeks to identify the TWOC failure incidence and risk factors to inform clinical decisions and enhance patient counselling. METHODS: We conducted a retrospective review of non-catheter dependent patients who underwent Rezūm therapy between April 2019 and June 2023 in two high-volume Canadian centers. All patients received a urinary catheter post-treatment. International Prostate Symptom Score (IPSS), Quality of Life (QoL), Maximum Urinary Flow Rate (Qmax), Postvoid Residual (PVR) were evaluated. Risk factors for TWOC failure were determined through logistic regression. RESULTS: Out of 406 patients, 99 patients (24.4%) failed TWOC on first attempt. The median time to TWOC was 7 days (range 3-30 days). Successful and failure groups had no significant difference in terms of average catheterization time (p=0.79), baseline prostate volume (p=0.288), PVR (p=0.35) or total number of injections per prostate volume ratio (p=0.89) (Table 1). A higher rate of urinary tract infection was observed in the TWOC failure group (10.6% vs. 2.6%, p=0.003). During follow-up, 12 patients experienced urinary retention. Patients who failed first TWOC were 7 times more likely to present with retention during follow-up (OR 7.0 95% CI 2.1-23.9, p=0.002). Patients failing their TWOC experienced retention sooner at a mean time to retention of 3.7±3.7 months vs. 21±11.5 months in the successful TWOC group (p=0.002). Baseline PVR was not a risk factor for failed TWOC in our cohort (p=0.95). Higher IPSS was the only predictor for TWOC failure (OR 1.04 95% CI: 1.01-1.08). CONCLUSIONS: About one in four patients failed first TWOC after Rezūm therapy. High baseline IPSS was identified as the only risk factor for TWOC failure in our cohort. Despite this, overall urinary symptoms improved in all patients. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e430 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Roseanne Ferreira More articles by this author Naeem Bhojani More articles by this author Bilal Chughtai More articles by this author Kevin C. Zorn More articles by this author Dean Elterman More articles by this author Expand All Advertisement PDF downloadLoading ...