Efficacy and safety of the Rezum system for the treatment of catheter-dependent urinary retention: Three-year real-world outcomes in a multimorbid, multiethnic population

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms Pub Date : 2023-05-15 DOI:10.1111/luts.12482

Mustufa Babar, Zaki Masoud, Kevin Labagnara, Justin Loloi, Rahman Sayed, Sandeep Singh, Kevin Tang, Umar Syed, Michael Ciatto

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引用次数: 1

Abstract

Objectives

To evaluate the long-term real-world efficacy and safety of Rezum for the treatment of catheter-dependent urinary retention in a multimorbid, multiethnic population.

Methods

A single-office, retrospective study was conducted on patients treated with Rezum between 2017 and 2019. Patients were included if they had catheter-dependent urinary retention prior to treatment and at least one follow-up within 36 months postoperatively. Patient demographics, procedural characteristics, adverse events (AEs), and outcome measures, including benign prostate hyperplasia (BPH) medication usage and postvoid residual (PVR), were collected at 3, 6, 12, and/or 36 months postoperatively. Regret was assessed at 36 months using the 5-item Decisional Regret Scale (DRS).

Results

A total of 27 patients met the inclusion criteria, with the majority being Asian (29.6%), followed by non-Hispanic Black (26.0%) and Hispanic (22.2%). Most patients (77.8%) had at least one comorbidity. Trial of void (TOV) was attempted at a median of 8 days (7, 13). Fourteen patients (51.9%) failed their initial TOV. Median time until catheter independence was 13.5 days (8.5, 28.8). Common AEs included urinary retention (51.9%), urinary tract infections (UTIs) (25.9%), and dysuria (25.9%). All cases of UTIs (7/7) and most cases of dysuria (6/7) occurred in patients who failed their initial TOV. At 36 months, there was a significant median percentage change in PVR (−100.0% [−100.0, −36.7], p = .049), and 40.4% of patients discontinued their BPH medications (p = .001). Of the 11 patients who filled out the DRS, 10 (90.9%) agreed/strongly agreed that they made the right decision. By 36 months, 4 patients (14.8%) underwent reoperation and 24 (88.9%) remained catheter-independent.

Conclusions

At long-term follow-up, Rezum effectively treated catheter-dependent urinary retention with minimal decisional regret. In patients with urinary retention, urologists should consider delaying TOV until 2 weeks postoperatively to maximize the likelihood of a successful TOV and minimize the risk of AEs.

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Rezum系统治疗导尿管依赖性尿潴留的有效性和安全性:在多疾病、多种族人群中的三年真实结果

目的评价Rezum在多疾病、多种族人群中治疗导尿管依赖性尿潴留的长期疗效和安全性。方法对2017 - 2019年接受Rezum治疗的患者进行单室回顾性研究。如果患者在治疗前有导尿管依赖性尿潴留，且术后36个月内至少有一次随访，则纳入研究。在术后3、6、12和/或36个月收集患者人口统计学、手术特征、不良事件(ae)和结局指标，包括良性前列腺增生(BPH)药物使用和术后残留(PVR)。在36个月时使用5项决策后悔量表(DRS)评估后悔。结果符合纳入标准的患者共27例，以亚裔(29.6%)居多，其次是非西班牙裔黑人(26.0%)和西班牙裔(22.2%)。大多数患者(77.8%)至少有一种合并症。无效试验(TOV)的中位数为8天(7,13)。14例(51.9%)患者首次TOV失败。到导管独立的中位时间为13.5天(8.5天，28.8天)。常见的ae包括尿潴留(51.9%)、尿路感染(25.9%)和排尿困难(25.9%)。所有尿路感染病例(7/7)和大多数排尿困难病例(6/7)发生在首次TOV失败的患者中。在36个月时，PVR的中位百分比变化显著(- 100.0% [- 100.0，- 36.7]，p = 0.049)， 40.4%的患者停止了BPH药物治疗(p = 0.001)。在填写DRS的11名患者中，10名(90.9%)同意或强烈同意他们做出了正确的决定。36个月时，4例患者(14.8%)再次手术，24例患者(88.9%)保持导管独立。结论:在长期随访中，Rezum有效地治疗了导尿管依赖性尿潴留，决策后悔最小。对于有尿潴留的患者，泌尿科医生应考虑延迟TOV至术后2周，以最大限度地提高TOV成功的可能性，并尽量减少不良反应的风险。

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来源期刊

LUTS: Lower Urinary Tract Symptoms UROLOGY & NEPHROLOGY-

CiteScore

3.00

自引率

7.70%

发文量

审稿时长

>12 weeks

期刊介绍： LUTS is designed for the timely communication of peer-reviewed studies which provides new clinical and basic science information to physicians and researchers in the field of neurourology, urodynamics and urogynecology. Contributions are reviewed and selected by a group of distinguished referees from around the world, some of whom constitute the journal''s Editorial Board. The journal covers both basic and clinical research on lower urinary tract dysfunctions (LUTD), such as overactive bladder (OAB), detrusor underactivity, benign prostatic hyperplasia (BPH), bladder outlet obstruction (BOO), urinary incontinence, pelvic organ prolapse (POP), painful bladder syndrome (PBS), as well as on other relevant conditions. Case reports are published only if new findings are provided. LUTS is an official journal of the Japanese Continence Society, the Korean Continence Society, and the Taiwanese Continence Society. Submission of papers from all countries are welcome. LUTS has been accepted into Science Citation Index Expanded (SCIE) with a 2011 Impact Factor.