Rezum for treating lower Urinary tract symptoms secondary to benign prostatic hyperplasia
Ref: Wang YY, Dimmock P, Dillon B, Islan E 2020, National Institute for Health and Care Excellence, https://www.nice.org.uk/guidance/mtg49.
This article provides information on the current evidence based recommendations of Rezum. As a newer form of treatment for BPH it is important data is maintained to ensure patients see improvements with symptoms and quality of life. Below are key take-outs of findings thus far:
- It is a minimally invasive procedure for men with moderate to severe LUTS – those men aged 50 or over with a typical IPSS score of 13 and over and have a moderately enlarged prostate approx 30grams and 80grams. There is limited evidence on the efficacy of Rezum outside this cohort.
- Rezum is associated with improved quality of life and low risk of sexual dysfunction.
- The technology uses water vapour (steam) that is injected into the prostate through a single use device attached to a urological endoscope. The process is intended to disrupt cell membranes, leading to cell death and shrinking the prostate. The vapour in injected for 9 seconds during treatment and a maximum number of 15 full injections can be done with each delivery depending on the lobe of the prostate.
- Rezum is contraindicated for patients with a urinary sphincter implant and who have a penile prosthesis.
- Evidence Rezum is clinically effective– significant improvement seen in 3 month follow-up with improvements maintained throughout 4 years of follow up. Sexual dysfunction after treatment with Rezum was low with a few people reporting decrease in ejaculatory function but little change in erectile function.
- At this early stage there is no evidence that directly compared Rezum with other interventions for BPH.
- Urinary tract infection if a common complication after Rezum. The risk is higher for Rezum than UroLift which usually does not need a post operative catheter. Rezum UTI risk with catheter is estimated around 5-7% due to patients requiring a catheter in post op for approximately a week.
- 4.4% rate of surgical re- treatment after Rezum over 4 years follow-up. Re-treatment is most likely in the first year after the procedure.
· Rezum should be avoided in people with prostatitis or confirmed prostate cancer and it high risk of bleeding