Abe Junya, Kyoda Yuki, Haga Kazunori, Sasao Takumi, Nishiyama Daito, Nofuji Seisuke, Ichihara Koji, Matsuda Yohei, Toyota Tomohiro, Ueki Yohei, Konta Shuto, Nakayama Sho, Shibuya Jurai, Kobayashi Genki, Maehana Takeshi, Nakajima Yusuke, Masumori Naoya
Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan.
Sanjukai Urological Hospital, Sapporo, Hokkaido, Japan.
Int J Urol. 2025 Jul;32(7):804-810. doi: 10.1111/iju.70052. Epub 2025 Mar 29.
The Japanese guidelines for male lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH) recommend the water vapor energy therapy (WAVE) procedure only for patients in whom conventional BPH surgery is unsuitable due to advanced age or comorbidities. This study aims to evaluate the efficacy and safety of the WAVE procedure using the Rezum system in Japan.
This multicenter retrospective study included patients who underwent the WAVE procedure between August 2022 and December 2023. A total of 311 patients from 13 institutions were registered. The number of medications for LUTS was determined before surgery and 6 months after surgery. Additionally, voiding function and perioperative complications were analyzed.
Of the 311 patients, 291 were eligible for analysis. The mean number of LUTS medications significantly decreased from 1.4 to 0.6 (p < 0.001). The mean maximum urinary flow rate significantly improved from 9.8 mL/s preoperatively to 12.2 mL/s at 6 months postoperatively (p < 0.001). The mean post-void residual volume also significantly decreased from 124 to 78 mL (p < 0.001). Furthermore, the mean total International Prostate Symptom Score significantly improved from 17.8 to 8.9 (p < 0.001). Complications classified as Clavien-Dindo Grade III or higher occurred in four cases (1.2%).
This large-scale, multicenter study demonstrates that the WAVE procedure improves LUTS, reduces the number of LUTS medications, and is both effective and safe for elderly patients with multiple comorbidities in Japan.
日本男性下尿路症状（LUTS）和良性前列腺增生（BPH）指南仅推荐水蒸气能量疗法（WAVE）用于因高龄或合并症而不适合传统BPH手术的患者。本研究旨在评估日本使用Rezum系统的WAVE手术的疗效和安全性。
这项多中心回顾性研究纳入了2022年8月至2023年12月期间接受WAVE手术的患者。来自13家机构的311名患者登记在册。在手术前和手术后6个月确定LUTS的用药数量。此外，还分析了排尿功能和围手术期并发症。
311例患者中，291例符合分析条件。LUTS用药的平均数量从1.4显著降至0.6（p<0.001）。平均最大尿流率从术前的9.8 mL/s显著提高到术后6个月的12.2 mL/s（p<0.001）。平均排尿后残余尿量也从124 mL显著降至78 mL（p<0.001）。此外，平均国际前列腺症状总评分从17.8显著提高到8.9（p<0.001）。4例（1.2%）发生了Clavien-Dindo III级或更高等级的并发症。
这项大规模、多中心研究表明WAVE手术可改善LUTS，减少LUTS用药数量，对日本患有多种合并症的老年患者有效且安全。
