Editorial Comment on Comparative Analysis of 3‐Year Reintervention Rates for Rezum vs. Urolift: A TriNetX Study

The study by Lu et al. provides real-world evidence comparing water vapor thermal therapy (Rezūm) and prostatic urethral lift (PUL/UroLift) using the TriNetX database [1]. This large study significantly contributes to the BPH management paradigm. The authors demonstrated comparable overall 3-year reintervention rates, but Rezūm showed a significantly lower rate among men aged ≥ 65 years. These findings generate important hypotheses regarding patient selection and durability. Reintervention serves as a pragmatic proxy for treatment durability, carrying immediate clinical relevance. However, it is not a pure measure of efficacy. The decision to retreat is influenced by objective symptom recurrence, patient expectations, physician preferences, and local therapy availability. Thus, reinter-vention rates reflect a composite clinical outcome rather than procedural efficacy alone. The findings must be interpreted alongside prior data. The pivotal Rezūm trial reported a 5-year retreatment rate of 4.4% (57% follow-up) [2], whereas the L.I.F.T. trial for UroLift reported 13.6% (74% follow-up) [3]. Direct comparisons are restricted by differing follow-up rates and baseline characteristics. A real-world study by Chin et al. also demonstrated lower retreatment rates for Rezūm than PUL [4]. Interestingly, while previous medium-term data favored Rezūm, the TriNetX analysis shows comparable