BACKGROUND Water vapor thermal therapy utilizes convectively delivered thermal energy to target ablation of obstructive prostatic tissue. We report results of this thermal therapy for relief of nonneurogenic complete urinary retention associated with BPH. PATIENTS AND METHODS We conducted a retrospective analysis of 38 catheter-dependent men with complete urinary retention consecutively enrolled in a registry in two centers: median age 75.5 years and multiple comorbidities, median prostate volume 58.5 cc (23-153), median 2 failed trials without catheter (TWOCs), and median catheter dependency 3 months (0.3-35). The Rezūm™ System thermal therapy procedure was performed in an ambulatory surgery center with conscious sedation or an office procedure room with a modified periprostatic block. Water vapor injections were customized to the configuration of the hyperplastic gland, including median lobe and/or enlarged central zone. RESULTS Of the 38 treated patients, one was lost to follow-up and 26 of 37 (70.3%) voided spontaneously (mean of 1.6 ± 0.8 TWOCs) and were catheter free a median of 26 days (range 4-65) after the procedure; 18 of these 26 (69%) patients discontinued BPH medications. No significant differences in age, prostate volume, number of water vapor injections, or presence of the median lobe were associated with predicting a successful treatment outcome. Duration of follow-up for 20 catheter-free patients was a median of 475 days or 15.8 months (140-804 days); six patients were followed a median of 31.5 days (0-60). Adverse events were infrequent, mild, and resolved quickly including dysuria in five patients (13%), gross hematuria in four (10.5%), and UTIs in two (2.6%) with indwelling catheters. CONCLUSIONS Water vapor thermal therapy may provide an effective and safe alternative to surgical treatment in this group of catheter-dependent patients in complete urinary retention.

中文翻译：

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水蒸气热疗法可缓解继发于良性前列腺增生的导管依赖性尿潴留。

背景技术水蒸气热疗利用对流传递的热能来靶向消融阻塞性前列腺组织。我们报告了这种热疗法缓解与 BPH 相关的非神经源性完全尿潴留的结果。患者和方法 我们对在两个中心连续登记的 38 名完全尿潴留的导管依赖型男性进行了回顾性分析：中位年龄 75.5 岁和多种合并症，中位前列腺体积 58.5 cc (23-153)，中位 2 次失败试验无导管 (TWOCs)，中位导管依赖 3 个月 (0.3-35)。Rezūm™ 系统热疗程序是在具有清醒镇静作用的门诊手术中心或具有改进的前列腺周围阻滞的办公室手术室中进行的。水蒸气注射是根据增生腺体的配置进行定制的，包括中叶和/或扩大的中心区。结果 在 38 名接受治疗的患者中，1 名失访，37 名患者中有 26 名（70.3%）自发排尿（平均 1.6 ± 0.8 TWOCs），术后中位 26 天（范围 4-65 天）无导管; 这 26 名患者中有 18 名 (69%) 停止了 BPH 药物治疗。年龄、前列腺体积、水蒸气注射次数或正中叶的存在与预测成功的治疗结果没有显着差异。20 名无导管患者的随访时间中位数为 475 天或 15.8 个月（140-804 天）；6 名患者的中位随访时间为 31.5 天（0-60 天）。不良事件不常见、轻微且迅速消退，包括 5 名患者 (13%) 的排尿困难，4 例 (10.5%) 肉眼血尿，2 例 (2.6%) 留置导管出现尿路感染。结论水蒸气热疗可能为这组完全尿潴留的导管依赖患者提供一种有效且安全的替代手术治疗的方法。