Babar Mustufa, Loloi Justin, Azhar Umair, Tang Kevin, Ines Matthew, Singh Sandeep, Iqbal Nazifa, Ciatto Michael
Albert Einstein College of Medicine, Bronx, New York, USA.
DSS Urology, Queens Village, New York, USA.
J Endourol. 2023 Feb;37(2):157-164. doi: 10.1089/end.2022.0390. Epub 2022 Oct 6.
To assess efficacy and safety outcomes in relationship to the number of injections given during Rezum treatment. A retrospective study was conducted on patients with moderate to severe lower urinary tract symptoms (LUTS) treated with Rezum. Patients were stratified into cohorts based on the number of injections received per lateral prostatic lobe: 1, 2, 3, or 4 injections. International Prostate Symptom Score (IPSS), quality of life (QoL), maximum urinary flow rate (Qmax), postvoid residual (PVR), International Index of Erectile Function (IIEF)-Erectile Function, IIEF-Orgasmic Function, and adverse events were collected at baseline, 1, 3, 6, and/or 12 months postoperatively. A total of 179 patients were included: 58, 91, 22, and 8 patients in the 1, 2, 3, and 4 injections cohorts, respectively. Baseline demographics significantly different across cohorts were age, history of urinary retention, prostate-specific antigen, prostate volume, prostatic urethral length, and presence of median lobe. At 3 months, all cohorts reported significant improvements in IPSS and QoL, which remained durable to 12 months. There were no significant differences in changes in IPSS, QoL, PVR, and IIEF-Erectile and Orgasmic Function between the cohorts at any follow-up. Multiple linear regression showed that the number of injections did not predict changes in IPSS, QoL, PVR, and IIEF-Erectile and Orgasmic Function at any follow-up ( > 0.05) but predicted change in Qmax at 3 months ( = 5.7, = 0.019). Multiple logistic regression showed that for each additional injection, the odds of gross hematuria, penile burning, penile pain, and dysuria increased by 3.8, 2.6, 2.2, and 3.0, respectively. Utilizing less injections represents a safe treatment strategy without compromising Rezum's efficacy in providing durable relief in LUTS.
评估Rezum治疗期间注射次数与疗效和安全性结果之间的关系。对接受Rezum治疗的中重度下尿路症状（LUTS）患者进行了一项回顾性研究。根据每侧前列腺叶接受的注射次数将患者分层为不同队列：1次、2次、3次或4次注射。在基线、术后1个月、3个月、6个月和/或12个月收集国际前列腺症状评分（IPSS）、生活质量（QoL）、最大尿流率（Qmax）、残余尿量（PVR）、国际勃起功能指数（IIEF）-勃起功能、IIEF-性高潮功能和不良事件。共纳入179例患者：1次、2次、3次和4次注射队列分别有58例、91例、22例和8例患者。各队列之间基线人口统计学有显著差异的因素包括年龄、尿潴留病史、前列腺特异性抗原、前列腺体积、前列腺尿道长度和中叶的存在情况。在3个月时，所有队列的IPSS和QoL均有显著改善，且持续至12个月。在任何随访中，各队列之间IPSS、QoL、PVR以及IIEF-勃起功能和性高潮功能的变化均无显著差异。多元线性回归显示，在任何随访中，注射次数均不能预测IPSS、QoL、PVR以及IIEF-勃起功能和性高潮功能的变化（P＞0.05），但可预测3个月时Qmax的变化（β = 5.7，P = 0.019）。多元逻辑回归显示，每增加一次注射，肉眼血尿、阴茎烧灼感、阴茎疼痛和尿痛的几率分别增加3.8、2.6、2.2和3.0。采用较少的注射次数是一种安全的治疗策略，且不影响Rezum在持久缓解LUTS方面的疗效。
