A comparative analysis of the outcomes of Rezūm therapy based on prostate size: a four-year retrospective analysis.

Objective: To assess the safety and efficacy of Rezūm therapy in small versus large prostates through a four-year follow-up.

Patients And Methods: One-hundred seventy patients who underwent Rezūm therapy were retrospectively included and divided into 2 equal groups, small (˂ 80gm) and large prostate groups (80-120 gm). Both groups were assessed preoperatively and at 3, 12, 24, 36, and 48 months post-procedure for operative time, number of vapor injection, catheterization time, hospital stay and post-procedure: prostatic size, prostate-specific antigen (PSA), post-void residual (PVR), maximum urinary flow rate (Qmax), International Prostate Symptom Score (IPSS), quality of life (QoL), International Index of Erectile Function (IIEF) and complications.

Results: The number of vapor injections was significantly higher in the large prostate group compared to the small prostate group (p < 0.001). Operative time and catheter duration were significantly longer in the large prostate group (p < 0.001), while hospital stay was similar between groups (p = 0.407). At 48 months post-Rezūm, both groups demonstrated statistically significant improvement in all measured outcomes (Qmax, IPSS, PVR, QoL, PSA, IIEF, and prostate size) (p < 0.05). Regarding postoperative complications, there were no significant differences between the groups except that the need for retreatment was significantly higher in the large prostate group.

Conclusion: Rezūm therapy offers a safe and effective treatment option for both small and large prostates with sustained improvement over four years. However, patients with large prostates exhibited a higher retreatment rate (15.2%).