Water vapor thermal therapy for patients with large prostates (≥ 80 mL): initial real-world data from China.

PURPOSE

To evaluate the safety and efficacy of water vapor thermal therapy (WVTT) in Chinese patients with large prostates (≥ 80 mL).

METHODS

A retrospective analysis was conducted on patients with large prostates (≥ 80 mL) who underwent WVTT between January 2023 and September 2024. Symptom scores, including the International Prostate Symptom Score (IPSS), Overactive Bladder Symptom Score (OABSS), and IPSS Quality of Life (QoL), along with clinical outcomes, were assessed.

RESULTS

A total of 57 patients (mean age: 73.88 ± 8.71 years; mean prostate volume: 109.27 ± 27.74 mL) were analyzed. Prostatic median lobe was identified in 64.91% (37/57) of patients. The mean surgical time was 29.13 ± 17.36 min, with 12.98 ± 2.19 vapor injections per patient. At 3 months after surgery, 39 patients completed the follow-up. Significant improvements were observed, including a 51.31% reduction in IPSS (p < 0.001) and a 56.50% improvement in IPSS QoL (p < 0.001). Patients with a prostatic median lobe were younger (mean age: 71.97 ± 8.94 vs. 77.40 ± 7.04 years, p = 0.041) and required more vapor injections (13.43 ± 1.95 vs. 12.11 ± 2.36, p = 0.040). No Clavien-Dindo grade III complications occurred, and the surgical re-treatment rate was 5.13% (2/39).

CONCLUSIONS

WVTT resulted in significant improvements in symptoms and quality of life for Chinese patients with large prostates, with low re-treatment rates and minimal complications at the 3-month follow-up. Larger cohorts and longer follow-up are needed for further evaluation.