Rezūm water vapor therapy vs. thulium laser enucleation for the treatment of benign prostatic hyperplasia in patients with large prostates: a multicenter prospective comparative study.

IF 5.8 2区医学 Q1 ONCOLOGY

Prostate Cancer and Prostatic Diseases Pub Date : 2025-04-14 DOI:10.1038/s41391-025-00971-y

Celeste Manfredi, Lorenzo Spirito, Carmelo Quattrone, Francesco Bottone, Lorenzo Romano, Raffaele Balsamo, Francesco Trama, Felice Crocetto, Biagio Barone, Luigi Napolitano, Savio Domenico Pandolfo, Antonio Franco, Francesco Ditonno, Francesco Uricchio, Giovanni Di Lauro, Ferdinando Fusco, Javier Romero-Otero, Cosimo De Nunzio, Riccardo Autorino, Marco De Sio, Davide Arcaniolo

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引用次数: 0

Abstract

Background: Despite the growing body of evidence supporting the use Rezūm in patients with benign prostatic hyperplasia (BPH) and large prostates, comparative studies with the current gold standard in this clinical setting are lacking.

Aim: To compare the efficacy and safety of Rezūm and Thulium Laser Enucleation of the Prostate (ThuLEP) in patients with BPH and large prostates.

Methods: We conducted a multicenter prospective comparative study. Consecutive patients with prostate volume (PV) ≥ 80 mL undergoing ThuLEP or Rezūm were included. Patient evaluation was performed at baseline and at 3, 6, and 12 months after surgery. International Prostate Symptom Score (IPSS)-Total was chosen as the primary outcome, while International Index of Erectile Function (IIEF-EF), four-item version of Male Sexual Health Questionnaire (MSHQ-EjD Short Form), and postoperative complications Clavien-Dindo (CD) grade ≥ III were selected as the secondary outcomes.

Results: A total of 246 patients were enrolled (126 ThuLEP, 120 Rezūm). Mean (SD) PV was 106.0 (16.5) mL in the ThuLEP group and 101.4 (14.8) mL in the Rezūm group (p = 0.55). Mean (SD) IPSS-Total was statistically significantly lower in the ThuLEP group compared to the Rezūm group at every postoperative time point (p < 0.001); however, the difference between the mean values never reached the Minimal Clinically Important Difference (MCID). IIEF-EF score significantly improved in both groups (p < 0.001), with no significant difference between the two procedures. Significant differences in MSHQ-EjD Function and Bothers in favor of Rezūm were observed at all postoperative time points (p < 0.001). Bleeding with clots requiring reintervention (CD ≥ III) for hemostasis and evacuation occurred in 5 (3.96%) men undergoing ThuLEP and 1 (0.83%) man undergoing Rezūm (p = 0.21).

Conclusions: Both ThuLEP and Rezūm significantly improve urinary symptoms in patients with BPH and large prostates. ThuLEP appears statistically but not clinically superior to Rezūm in improving LUTS.

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Rezūm水蒸汽疗法与铥激光去核治疗大前列腺患者的良性前列腺增生：一项多中心前瞻性比较研究。

背景：尽管越来越多的证据支持在良性前列腺增生（BPH）和大前列腺患者中使用Rezūm，但在这种临床环境中缺乏与当前金标准的比较研究。目的：比较Rezūm与铥激光前列腺除核术（ThuLEP）治疗前列腺增生及大前列腺的疗效和安全性。方法：我们进行了一项多中心前瞻性比较研究。纳入前列腺体积(PV)≥80ml连续接受ThuLEP或Rezūm治疗的患者。在基线和术后3、6、12个月对患者进行评估。以国际前列腺症状评分（IPSS）总分作为主要结局，以国际勃起功能指数（IIEF-EF）、四项版男性性健康问卷（MSHQ-EjD简式）和术后并发症Clavien-Dindo （CD）分级≥III为次要结局。结果：共纳入246例患者（126例ThuLEP， 120例Rezūm）。ThuLEP组的平均（SD） PV为106.0 (16.5)mL， Rezūm组的平均（SD） PV为101.4 (14.8)mL （p = 0.55）。术后各时间点，ThuLEP组的平均（SD） IPSS-Total均显著低于Rezūm组(p)。结论：ThuLEP和Rezūm均可显著改善BPH和大前列腺患者的泌尿系统症状。在改善LUTS方面，ThuLEP在统计学上优于Rezūm，但在临床上不优于Rezūm。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Prostate Cancer and Prostatic Diseases 医学-泌尿学与肾脏学

CiteScore

10.00

自引率

6.20%

发文量

142

审稿时长

6-12 weeks

期刊介绍： Prostate Cancer and Prostatic Diseases covers all aspects of prostatic diseases, in particular prostate cancer, the subject of intensive basic and clinical research world-wide. The journal also reports on exciting new developments being made in diagnosis, surgery, radiotherapy, drug discovery and medical management. Prostate Cancer and Prostatic Diseases is of interest to surgeons, oncologists and clinicians treating patients and to those involved in research into diseases of the prostate. The journal covers the three main areas - prostate cancer, male LUTS and prostatitis. Prostate Cancer and Prostatic Diseases publishes original research articles, reviews, topical comment and critical appraisals of scientific meetings and the latest books. The journal also contains a calendar of forthcoming scientific meetings. The Editors and a distinguished Editorial Board ensure that submitted articles receive fast and efficient attention and are refereed to the highest possible scientific standard. A fast track system is available for topical articles of particular significance.