Division of Urology, University Health Network, University of Toronto, Toronto, Ontario, Canada.
University of Montreal Hospital Center, Université de Montréal, Montreal, Quebec, Canada.
Can J Urol. 2022 Apr;29(2):11075-11079.
This analysis reported outcomes of treating catheter-dependent urinary retention with Rezūm water vapor therapy.
A prospective registry was established at two high-volume Canadian centers. Patients had baseline medical and benign prostatic hyperplasia (BPH) history documented. The subgroup of patients with refractory, catheter-dependent urinary retention was analyzed. The primary outcome was the proportion of patients who were spontaneously voiding and catheter-free at 6 months.
Sixteen patients (age: 68.7 years) with catheter-dependent urinary retention were treated with Rezūm. Average prostate volume was 84.4 mL and 75% had median lobe. All patients had at least one recent failed trial without catheter (TWOC) and 87.5% were on BPH oral therapy. Mean number of vapor injections was 14.5. Visibility and bleeding during procedure were assessed using a 5-point scale, and were rated as 1.4 and 1.3, respectively. Anesthesia was either intravenous propofol sedation (n = 13) or self-administered methoxyflurane inhaler (n = 3). Mean catheter duration until first planned TWOC was 28.4 days. Three patients needed catheter replacement due to initial failed TWOC. One patient was lost to follow up, one patient did not return at 1 month, and one patient did not return at 3 months. At 1 month, 13/14 patients were spontaneously voiding and catheter-free. At 3 months, 14/14 patients were spontaneously voiding, and at 6 months, 15/15 patients were spontaneously voiding and catheter-free (1 patient was lost to follow up).
Rezūm water vapor therapy can successfully treat catheter-dependent urinary retention after initial failed TWOC in an outpatient setting.
本分析报告了使用 Rezūm 水蒸气疗法治疗依赖导管的尿潴留的结果。
在加拿大的两个高容量中心建立了一个前瞻性登记处。记录了患者的基线医疗和良性前列腺增生（BPH）病史。分析了难治性、依赖导管的尿潴留患者亚组。主要结果是 6 个月时自发排尿且无导管的患者比例。
16 例（年龄：68.7 岁）依赖导管的尿潴留患者接受了 Rezūm 治疗。平均前列腺体积为 84.4ml，75%有中叶。所有患者至少有一次近期无导管失败尝试（TWOC），87.5%接受 BPH 口服治疗。平均蒸气注射次数为 14.5 次。使用 5 分制评估手术过程中的可见度和出血程度，分别评为 1.4 和 1.3。麻醉为静脉注射异丙酚镇静（n=13）或自行使用甲氧氟烷吸入器（n=3）。首次计划 TWOC 前的平均导管持续时间为 28.4 天。由于最初的 TWOC 失败，有 3 例需要更换导管。1 例患者失访，1 例患者在 1 个月时未返回，1 例患者在 3 个月时未返回。1 个月时，14/14 例患者自发排尿且无导管；3 个月时，14/14 例患者自发排尿，6 个月时，15/15 例患者自发排尿且无导管（1 例患者失访）。
Rezūm 水蒸气疗法可在门诊环境中成功治疗初始 TWOC 失败后的依赖导管的尿潴留。
