Wirtzfeld Nathan, Moretto Stefano, Doizi Steeve
Urology Department, Cliniques universitaires Saint-Luc, Brussels, Belgium.
Sorbonne Université, GRC n°39, Santé de l'homme, Hôpital Tenon, Paris, F-75020, France.
World J Urol. 2025 Apr 25;43(1):252. doi: 10.1007/s00345-025-05537-0.
This narrative review analyzed current practices and protocols for local anesthesia in Rezūm™ and evaluated the feasibility, pain management, and patient comfort associated with this approach.
We included studies reporting the use of local anesthesia in Rezūm™, focusing on patient comfort and pain levels during the procedure. The literature search was performed in June 2024 using Medline, Cochrane, and Embase databases to identify relevant studies published from January 2015 to June 2024. Searches were restricted to publications in English. Owing the heterogeneity of study outcomes and the non-standardized quality appraisal, a narrative synthesis rather than a quantified meta-analysis of data was performed.
Four studies were included. Various local anesthesia methods, including transurethral intraprostatic anesthesia with the Schelin catheter and prostatic nerve block associated with cold anesthetic gel, are effective in managing pain and can facilitate the performance of Rezūm™ in outpatient settings. Functional outcomes, including improved Qmax, reduced IPSS and QoL scores, and high catheter independence rates, were reported, with minor complications.
Rezūm™ performed under local anesthesia is feasible, offering significant advantages in terms of patient comfort and potential for outpatient application. However, the lack of standardized protocols and the need for further research on long-term outcomes and comparative efficacy are critical areas for future investigation. Addressing these challenges could optimize Rezūm™, making them more accessible and cost-effective and potentially shifting BPH management toward more office-based procedures.
本叙述性综述分析了Rezūm™局部麻醉的当前实践和方案，并评估了这种方法的可行性、疼痛管理以及患者舒适度。
我们纳入了报告在Rezūm™中使用局部麻醉的研究，重点关注手术过程中的患者舒适度和疼痛程度。2024年6月使用Medline、Cochrane和Embase数据库进行文献检索，以识别2015年1月至2024年6月发表的相关研究。检索仅限于英文出版物。由于研究结果的异质性和质量评估的不标准化，因此进行了叙述性综合分析而非数据的定量荟萃分析。
纳入了四项研究。各种局部麻醉方法，包括使用谢林导管进行经尿道前列腺内麻醉以及与冷麻醉凝胶相关的前列腺神经阻滞，在疼痛管理方面均有效，并且可以促进Rezūm™在门诊环境中的操作。报告了包括改善最大尿流率（Qmax）、降低国际前列腺症状评分（IPSS）和生活质量（QoL）评分以及高导管自主排尿率等功能结局，并伴有轻微并发症。
在局部麻醉下进行Rezūm™是可行的，在患者舒适度和门诊应用潜力方面具有显著优势。然而，缺乏标准化方案以及对长期结局和比较疗效进行进一步研究的必要性是未来研究的关键领域。应对这些挑战可以优化Rezūm™，使其更易于获得且更具成本效益，并可能将良性前列腺增生（BPH）管理转向更多基于门诊的手术。
