Department of Surgery, Division of Urology, King Abdullah Medical City at Holy Capital, Makkah, Saudi Arabia.
Faculty of Medicine, Urology Department, King Abdulaziz University, Jeddah, Saudi Arabia.
World J Urol. 2024 Jan 20;42(1):48. doi: 10.1007/s00345-023-04739-8.
To compare the efficacy of Rezūm with a matched cohort of patients undergoing transurethral resection of the prostate (TURP) for catheter-dependent urine retention secondary to benign prostate hyperplasia (BPH).
A retrospective review was performed for consecutive catheter-dependent patients who underwent Rezūm for BPH. Patients were matched and compared with a similar cohort undergoing TURP, using non-inferiority analysis on propensity score-matched patient pairs. Patients were followed up at 1, 3, 6 and 12 months by international prostate symptoms score (IPSS), quality of life (QoL) index, peak flow rate (Qmax) and postvoid residual urine (PVR).
Eighty-one patients undergoing Rezūm were compared with equal number of matched patients who undergoing TURP. Patients undergoing Rezūm experienced significantly shorter operation time (25.5 ± 8.7 vs. 103.4 ± 12.6 min; p < 0.001), lower intraoperative bleeding (2.4% vs. 20.7%, p < 0.001), shorter hospital stay (1.2 ± 0.9 vs. 2.4 ± 1.3 d, p < 0.001) and longer catheter time (12.6 ± 6.0 vs. 2.3 ± 1.2 d, p < 0.001), with no need for transfusion. Successful postoperative voiding was comparable between both arms (90.2% vs. 92.7%, p = 0.78), respectively. Despite patients undergoing TURP had significantly better voiding outcomes after 1 and 3 months, both groups were comparable after six and 12 months in terms of mean IPSS (11.1 ± 6.4 vs. 10.8 ± 3.4, p = 0.71), QoL indices (2.4 ± 1.6 vs. 2.1 ± 2.3, p = 0.33) and Qmax (22.0 ± 7.7 v. 19.8 ± 6.9 ml/sec, p = 0.06).
This study supports the safety and efficacy of Rezūm in the management of catheter-dependent patients secondary to BPH, with comparable functional outcomes to TURP. Until a randomized clinical comparison is available, long-term data are crucially recommended to compare the recurrence and reoperation rates.
比较 Rezūm 与经尿道前列腺切除术（TURP）治疗良性前列腺增生（BPH）继发导尿管依赖型尿潴留的疗效。
对连续接受 Rezūm 治疗的导尿管依赖型 BPH 患者进行回顾性研究。使用倾向评分匹配的患者对进行非劣效性分析，将患者与接受 TURP 治疗的相似队列进行匹配和比较。通过国际前列腺症状评分（IPSS）、生活质量（QoL）指数、最大尿流率（Qmax）和剩余尿量（PVR）对患者在 1、3、6 和 12 个月时进行随访。
81 例接受 Rezūm 治疗的患者与接受 TURP 治疗的患者数量相等。与接受 TURP 治疗的患者相比，接受 Rezūm 治疗的患者手术时间明显缩短（25.5±8.7 比 103.4±12.6 分钟；p<0.001），术中出血量减少（2.4%比 20.7%；p<0.001），住院时间缩短（1.2±0.9 比 2.4±1.3 天；p<0.001），导尿管留置时间延长（12.6±6.0 比 2.3±1.2 天；p<0.001），无需输血。两组术后排尿成功率相似（90.2%比 92.7%；p=0.78）。尽管接受 TURP 治疗的患者在术后 1 个月和 3 个月的排尿效果明显更好，但在术后 6 个月和 12 个月时，两组在平均 IPSS（11.1±6.4 比 10.8±3.4；p=0.71）、QoL 指数（2.4±1.6 比 2.1±2.3；p=0.33）和 Qmax（22.0±7.7 比 19.8±6.9 ml/sec；p=0.06）方面无显著差异。
本研究支持 Rezūm 在治疗 BPH 继发导尿管依赖型患者中的安全性和有效性，其功能结局与 TURP 相当。在随机临床比较可用之前，强烈建议提供长期数据以比较复发和再次手术率。
