[Efficacy and safety of minimally invasive injection steam therapy for lower urinary tract symptoms caused by benign prostate hyperplasia (first clinical experience in the Russian Federation)].

INTRODUCTION

Currently, the development of new methods of treatment of benign prostatic hyperplasia (BPH) is continuing, combining the high efficiency of transurethral resection of the prostate, which are safer for elderly patients and provide a high level of quality of life for younger patients. One of these new methods is minimally invasive water vapor thermal therapy.

AIM

To evaluate the efficiency and safety of water vapor thermal therapy in patients with lower urinary tract symptoms (LUTS)/BPH.

MATERIALS AND METHODS

A total of 35 patients with LUTS/BPH who were treated between September 2022 and September 2024 (median follow-up of 12 months) were included in the study. The average age was 68.7+/-1.5 years. The prostate volume did not exceed 80 cc (52.4+/-4.2 cc). The Qmax was 9.3+/-0.7 ml/sec. The postvoid residual volume (PVR) was 73.6+/-12.2 ml. The overall IPSS score was 26.5+/-2.3 and QoL was 4.3+/-0.3. All patients were treated with water vapor thermal therapy according to the standard procedure recommended by the manufacturer (5.7+/-0.72 injections of water vapor into the prostate). The efficacy was evaluated every 3 months after the procedure. Intra- and postoperative complications were assessed on Clavien-Dindo classification.

RESULTS

After 3 months, 97.1% (34 out of 35) of patients had an improvement in objective urination parameters. Qmax and PVR after 3 months increased up to 17.3+/-1.5 ml/sec and 20.8+/-7.2 ml, respectively (p<0.05 compared with baseline values). There was also a significant decrease in IPSS and QoL levels, 8,5+/-1,3 and 2,3+/-0,3, respectively (p<0,05 compared with the baseline). Qmax and PVR continued to improve till the 6 months of follow-up (17.6+/-1.1ml/sec and 14.3+/-0.8 ml, respectively, p<0.05 compared with baseline and after 3 months). There was also a significant decrease in IPSS and QoL to 4.1+/-1.3 and 1.4+/-0.1 points, respectively (p<0.05 compared to 3 months). After that, these values remained stable throughout the follow-up period. The overall efficiency of the treatment (at median follow-up of 12 months) was 88,6%. Perioperative complications occurred in 9 out of 35 patients (did not exceed IIIa according to Clavien-Dindo).

CONCLUSIONS

Minimally invasive water vapor thermal therapy is a new effective and safe method of treating patients with LUTS/BPH. After the procedure, there is a significant improvement in lower urinary tract symptoms.