良性攝護腺肥大患者接受Rezum水蒸氣消融手術：
單一醫學中心經驗

李宗翰¹、黃志賢^1,2、黃逸修^1,2、陳威任^1,2、顧明軒^1,2、許自翔^1,2、林志杰^1,2

¹臺北榮民總醫院泌尿部

²國立陽明交通大學醫學院泌尿學科 書田泌尿科學研究中心

Real-world outcomes of Rezum water vapor thermal therapy in patients with benign prostatic enlargement: A single-center experience

Tsung-Han Li¹, William J.S. Huang^1,2, Eric Yi-Hsiu Huang^1,2,

Wei-Jen Chen^1,2, Ming-Hsuan Ku^1,2, Tzu-Hsiang Hsu^1,2, Chih-Chieh Lin^1,2

¹Department of Urology, Taipei Veterans General Hospital

²Department of Urology, College of Medicine and Shu-Tien Urological Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan

Purpose:

Rezum water vapor thermal therapy has emerged as a minimally invasive option for benign prostatic enlargement (BPE), providing effective symptom relief with low morbidity. However, data from Asian populations are limited. This study aimed to evaluate the efficacy, safety, and procedural characteristics of Rezum therapy for BPE in a real-world clinical setting.

Materials & Methods:

We retrospectively analyzed 37 patients with BPE who underwent Rezum therapy at Taipei Veterans General Hospital between January 2024 and December 2024. Baseline parameters included age, prostate-specific antigen (PSA), prostate volume, International Prostate Symptom Score (IPSS) with subscores, quality of life (QoL), uroflowmetry parameters (Qmax, Qmean), and post-void residual urine (PVR). Treatment details (numbers of injections for left, right, and median lobes; catheterization duration; and postoperative acute urinary retention [AUR]) were recorded. Pre- and postoperative functional outcomes were compared using paired t-tests. The correlation between total injection number and prostate volume was assessed using Pearson correlation.

Results:

The median age was 64 years, and mean preoperative PSA was 4.06 ± 6.38 ng/mL. The mean total IPSS was 19.3 ± 7.1, with voiding and storage subscores of 11.4 ± 5.1 and 7.9 ± 3.3, respectively; mean QoL score was 4.05 ± 0.94. The mean prostate volume was 62.7 ± 33.6 mL, with 29 patients (78%) <80 mL and 8 patients (22%) ≥80 mL. The mean numbers of vapor injections were 2.78 ± 1.38 for the left lobe, 2.84 ± 1.41 for the right lobe, and 0.39 ± 0.73 for the median lobe (10 patients treated). The mean catheterization duration was 11.9 ± 7.93 days. Acute urinary retention after Rezum occurred in 5 patients (13.5%), all managed conservatively. At 3-month follow-up, significant symptomatic and functional improvements were observed. Mean total IPSS decreased from 19.1 ± 7.05 to 4.05 ± 2.91 (p < 0.0001); voiding subscore from 11.3 ± 5.01 to 1.16 ± 1.62 (p < 0.0001); storage subscore from 7.86 ± 3.25 to 2.89 ± 2.43 (p < 0.0001); and QoL from 4.05 ± 0.94 to 0.49 ± 1.02 (p < 0.0001). Uroflowmetry demonstrated increased Qmax from 11.3 ± 3.80 to 14.2 ± 6.61 mL/s (p = 0.0039), while PVR decreased from 52.2 ± 68.7 to 32.9 ± 53.1 mL (p = 0.0459). A strong positive correlation was found between total injection number and prostate volume (r = 0.733, p < 0.001).

Conclusions:

Rezum water vapor thermal therapy provides significant improvements in lower urinary tract symptoms, quality of life, and voiding function in men with BPE, with a low complication rate and acceptable catheterization duration. The number of injections correlates with prostate volume, suggesting its utility in individualized procedural planning. Further long-term follow-up is warranted to confirm durability of outcomes.