水蒸氣消融治療：良性前列腺增生的新型微創手術—單一中心經驗與病例系列報告

                                        謝佳駤¹、曾文歆^1,2、李高漢¹、黃冠華¹、邱文祥³

台南永康奇美醫院 外科部 泌尿科¹；國立中山大學生物醫學研究所²；台北新光吳火獅紀念醫院 泌尿科³

Water Vapor Thermal Therapy: A Novel Minimally Invasive Operation for Benign Prostate Hyperplasia – A Single-center Experience and Case Series

Chia-Chih Hsieh¹、Wen-Hsin Tseng^1,2、Kau-Han Lee¹、Steven K. Huang¹、Allen W.Chiu³

¹Division of Urology, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan;

²Division of Uro-Oncology, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan;

³Department of Urology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.

Purpose

Lower urinary tract symptoms (LUTS) in men often result from bladder outflow obstruction (BOO) due to benign prostatic hyperplasia (BPH). Transurethral resection of the prostate (TURP) was the traditional gold standard treatment; however, new minimally invasive surgical therapies (MISTs) have emerged. Water vapor thermal therapy (WVTT) with the Rezūm^® system, approved by the Taiwan Food and Drug Administration (TFDA) in 2022, is a novel option. According to American Urological Association (AUA) and Taiwan Urological Association (TUA) guidelines, WVTT is recommended for patients with prostate sizes of approximately 30-80 c.c. We present a case series from our medical center, demonstrating its use and effectiveness in treating BPH-related LUTS.

Materials and Methods

We retrospectively reviewed 30 BPH patients treated with Rezūm^® WVTT at our medical center from January to August 2024. Follow-up evaluations included Uroflowmetry and International Prostate Symptom Score (IPSS).

Results

Among the 30 patients (mean age 59.66 ± 9.35 years), the mean preoperative PSA level was 3.31 ± 5.3 ng/mL, and transrectal ultrasound (TRUS) showed an average prostate size of 44.94 ± 13.57 ml. The mean Rezūm^® WVTT operation time was 20.86 ± 7.47 minutes, with an average Foley catheter indwelling time of 8.8 days. Uroflowmetry performed preoperatively and 2 months postoperatively showed improvement in both average urinary flow rate (Q_mean) and maximum flow rate (Q_Max). Bladder voiding efficiency and IPSS scores also improved across items postoperatively.

Conclusions

This case series provides the treatment experiences of Rezūm^® WVTT at our medical center. It highlights the effectiveness in providing rapid and lasting relief for moderate to severe LUTS in BPH patients, positioning it as an attractive first-line treatment option.