Rowaiee Rashed, Akhras Aya, Lakshmanan Jeyaseelan, Sikafi Zuhair, Janahi Farhad
Urology, Mohammed Bin Rashid University of Health and Medical Sciences, Dubai, ARE.
Epidemiology and Biostatistics, Mohammed Bin Rashid University of Health and Medical Sciences, Dubai, ARE.
Cureus. 2021 Sep 18;13(9):e18083. doi: 10.7759/cureus.18083. eCollection 2021 Sep.
Introduction Symptomatic benign prostatic hyperplasia (BPH) is a condition that affects middle-aged men, leading to a decreased quality of life secondary to symptoms of difficult urination, urinary frequency, urgency and nocturia. The treatment modalities of this pathology include pharmacologic and invasive interventions, both of which vary in effectiveness and they come with a myriad of side effects. Recent advancements have allowed for the development of Rezum, a minimally invasive and effective approach to treating BPH while maintaining a good safety profile with comparable outcomes to other treatment modalities. Methods We retrospectively identified 49 patients with symptomatic BPH who underwent Rezum therapy in one center in Dubai, the United Arab Emirates between January and December 2020. We assessed several parameters related to their condition including prostate volume, pre-operative and post-operative post-void residual (PVR) and peak urinary flow (Qmax) number of treatments given, trial without catheter and mean date of follow-up. Safety and side effects were also assessed. Result Our sample included symptomatic men with a mean age of 64 (10) who had a mean follow-up time of three months (IQR 2-5.2), median prostatic volume of 58 cc (IQR 44-82) and a mean of (SD 33.9). The initial Qmax and PVR were 7.3 ml/s (IQR 5.5-10.3) and 80.4 cm(IQR 43.4-120.0) respectively, and post-operative Qmax and PVR were 16.3 ml/s (SD 5.7) and 20.7 cm (IQR 16.2-28.2). Post-operatively, we observed a significant increase in Qmax of 8.11 ml/s (p=0.001) post-operatively, a mean decrease of 94.32 cm (p=0.001) in PVR. The favorable outcome parameters in Qmax and PVR demonstrate the efficacy of this procedure. We have also noted that the change in Qmax and PVR does not vary by initial prostate volume. Conclusion In this report, we aimed to highlight the benefit, efficacy and safety of offering Rezum to patients with symptomatic BPH in a single center in Dubai, reporting on the first United Arab Emirates experience with this novel procedure. This procedure confers the benefit of being minimally invasive, safe and effective, and with lower rates of sexual dysfunction compared to medical therapy or trans-urethral resection of the prostate (TURP). It is associated with similar outcomes to TURP, and an improvement in quality of life, while carrying a low-risk profile. Our experience corresponds with the available literature regarding the efficacy and satisfaction rates of Rezum for BPH patients. We hope that results from this study encourage further investigation into the long-term implications of Rezum, up to five years post-operatively.
引言 有症状的良性前列腺增生（BPH）是一种影响中年男性的疾病，由于排尿困难、尿频、尿急和夜尿等症状，导致生活质量下降。这种疾病的治疗方式包括药物治疗和侵入性干预，两者的有效性各不相同，且都有大量副作用。最近的进展使得Rezum得以开发，这是一种微创且有效的治疗BPH的方法，同时保持良好的安全性，其效果与其他治疗方式相当。
方法 我们回顾性地确定了2020年1月至12月期间在阿拉伯联合酋长国迪拜的一个中心接受Rezum治疗的49例有症状的BPH患者。我们评估了与他们病情相关的几个参数，包括前列腺体积、术前和术后排尿后残余尿量（PVR）、最大尿流率（Qmax）、治疗次数、无导尿管试验和平均随访日期。还评估了安全性和副作用。
结果 我们的样本包括有症状的男性，平均年龄为64岁（10岁），平均随访时间为三个月（IQR 2 - 5.2），前列腺体积中位数为58 cc（IQR 44 - 82），平均为（标准差33.9）。初始Qmax和PVR分别为7.3 ml/s（IQR 5.5 - 10.3）和80.4 cm（IQR 43.4 - 120.0），术后Qmax和PVR分别为16.3 ml/s（标准差5.7）和20.7 cm（IQR 16.2 - 28.2）。术后，我们观察到Qmax术后显著增加8.11 ml/s（p = 0.001），PVR平均下降94.32 cm（p = 0.001）。Qmax和PVR的良好结果参数证明了该手术的有效性。我们还注意到Qmax和PVR的变化并不因初始前列腺体积而异。
结论 在本报告中，我们旨在强调在迪拜的一个单一中心为有症状的BPH患者提供Rezum的益处、疗效和安全性，报告阿拉伯联合酋长国首次使用这种新手术的经验。该手术具有微创、安全有效、与药物治疗或经尿道前列腺切除术（TURP）相比性功能障碍发生率较低的优点。它与TURP的结果相似，生活质量得到改善，同时风险较低。我们的经验与关于Rezum对BPH患者的疗效和满意度的现有文献相符。我们希望这项研究的结果能鼓励对Rezum术后长达五年的长期影响进行进一步研究。
