Head-to-head comparison of prostatic urethral lift and water vapor thermal therapy for the treatment of symptomatic benign prostatic hyperplasia: a real-life study.
Benign prostatic hyperplasia
Lower urinary tract symptoms
Minimally invasive surgical treatment
Prostatic urethral lift
Water vapor thermal therapy
Journal
International urology and nephrology
ISSN: 1573-2584
Titre abrégé: Int Urol Nephrol
Pays: Netherlands
ID NLM: 0262521
Informations de publication
Date de publication:
Sep 2021
Sep 2021
Historique:
received:
16
02
2021
accepted:
22
05
2021
pubmed:
31
5
2021
medline:
21
1
2022
entrez:
30
5
2021
Statut:
ppublish
Résumé
This study aimed at reporting a head-to-head comparison between water vapor thermal therapy using the Rezūm™ system and prostatic urethral lift using the Urolift™ system in men with lower urinary tract symptoms due to benign prostatic hyperplasia (BPH). From December 2017 to November 2019, consecutive patients who underwent Rezūm™ and Urolift™ procedures in two urology centers have been retrospectively considered. Only patients with a prostate size less than 80 mL were included. We used the PSM method to adjust baseline differences between both groups. The co-primary endpoint included the change in International Prostate Symptom Score (IPSS) and IPSS- quality of life (QoL) from baseline to 12 months. A total of 61 (52.1%) and 56 (47.9%) patients underwent Rezum™ and Urolift™ procedures, respectively. After PSM adjustment, 24 patients were included in both groups. No serious adverse events occurred (> Clavien II) in both groups. At 12 months, higher IPSS improvement was observed in the Rezum™ group (median:4 [IQR 3-5]) than in the Urolift™ group (median:8 [IQR 7-12]), without statistical difference (p = 0.08). The improvement in term of QoL at 12 m was similar (p = 0.43). The retreatment rates were 25% (Urolift™) and 8.3% (Rezum™), p = 0.24. Erection and ejaculatory function scores did not change significantly in either treatment group. Results in the full cohort showed that Rezum™ appeared to deliver greater improvements for IPSS and IPSS-QoL (p < 0.001 and p = 0.006, respectively) and lower reintervention rate (p = 0.006) than Urolift™. In this small retrospective study, our results indicate that both Rezum™ and Urolift™ provide a clinically significant improvement in symptoms and QoL, although some of these improvements were greater in the Rezum™ arm. Future studies are needed to definitively assess which treatment would be best suited for each patient.
Identifiants
pubmed: 34052957
doi: 10.1007/s11255-021-02899-3
pii: 10.1007/s11255-021-02899-3
doi:
Substances chimiques
Steam
0
Types de publication
Comparative Study
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1757-1763Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer Nature B.V.
Références
Gravas S, Cornu JN, Gacci M, Gratzke C, Herrmann TRW, Mamoulakis C et al (2020) EAU guidelines on non-neurogenic male lower urinary tract symptoms (LUTS), incl. European Association of Urology, Benign prostatic obstruction (BPO)
Reich O, Gratzke C, Bachmann A et al (2008) Morbidity, mortality and early outcome of transurethral resection of the prostate: a prospective multicenter evaluation of 10,654 patients. J Urol 180:246–249
doi: 10.1016/j.juro.2008.03.058
Cornu JN, Ahyai S, Bachmann A et al (2015) A systematic review and meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic obstruction: an update. Eur Urol 67:1066–1096
doi: 10.1016/j.eururo.2014.06.017
Madersbacher S, Roehrborn CG, Oelke M (2020) The role of novel minimally invasive treatments for lower urinary tract symptoms associated with benign prostatic hyperplasia. BJU Int 126(3):317–326
doi: 10.1111/bju.15154
Suarez-Ibarrola R, Miernik A, Gratzke C, Schoeb DS (2020) Reasons for new MIS. Let’s be fair: iTIND. World J Urol, Urolift and Rezūm. https://doi.org/10.1007/s00345-020-03453-z
doi: 10.1007/s00345-020-03453-z
Dornbier R, Pahouja G, Branch J, McVary KT (2020) The new american urological association benign prostatic hyperplasia clinical guidelines: 2019 Update. Curr Urol Rep 21(9):32
doi: 10.1007/s11934-020-00985-0
Roehrborn CG et al (2017) Five year results of the prospective randomized controlled prostatic urethral LIFT study. Can J Urol 24(3):8802–8813
pubmed: 28646935
Rukstalis D et al (2016) 24-month durability after crossover to the prostatic urethral lift from randomised, blinded sham. BJU Int 118(Suppl 3):14–22
doi: 10.1111/bju.13666
McVary KT, Rogers T, Roehrborn CG (2019) Rezum water vapor thermal therapy for lower urinary tract symptoms associated with benign prostatic hyperplasia: 4-year results from randomized con- trolled study. Urology 126:171–179
doi: 10.1016/j.urology.2018.12.041
Sonksen J et al (2015) Prospective, randomized, multinational study of prostatic urethral lift versus transurethral resection of the prostate: 12-month results from the BPH6 study. Eur Urol 68(4):643–652
doi: 10.1016/j.eururo.2015.04.024
Gratzke C et al (2017) Prostatic urethral lift vs transurethral resection of the prostate: 2-year results of the BPH6 prospective, multicentre, randomized study. BJU Int 119(5):767–775
doi: 10.1111/bju.13714
Alegorides C, Fourmarier M, Eghazarian C, Lebdai S, Chevrot A, Droupy S (2020) Treatment of benign prostate hyperplasia using the Rezum® water vapor therapy system: results at one year. Prog Urol S1166–7087(20):30166–30174
Beurrier S, Peyromaure M, Belas O, Barry N, Delongchamps. (2015) Are the UroLift(®) implants an alternative for the treatment of benign prostatic hyperplasia? Short-term results and predictive factors of failure. Prog Urol 25(9):523–529
doi: 10.1016/j.purol.2015.03.005
Mynderse LA, Hanson D, Robb RA et al (2015) Rezūm system water vapor treatment for lower urinary tract symptoms/benign prostatic hyperplasia: validation of convective thermal energy transfer and characterization with magnetic resonance imaging and 3-dimensional renderings. Urology 86(1):122–127
doi: 10.1016/j.urology.2015.03.021
McNicholas T, Woo H, Chin P et al (2013) Minimally invasive prostatic urethral lift: surgical technique and multinational experience. Eur Urol 64:292–299
doi: 10.1016/j.eururo.2013.01.008
Clavien PA, Sanabria JR, Strasberg SM (1992) Proposed classification of complications of surgery with examples of utility in cholecystectomy. Surgery 111:518–526
pubmed: 1598671
Userovici M, Ochoa A, Anract J, Beurrier S, Peyromaure M, Barry N, Delongchamps. (2020) Prostatic urethral lift using Urolift® system for benign prostatic hyperplasia: 7years experience. Prog Urol 30(3):147–154
doi: 10.1016/j.purol.2020.01.003
Tanneru K, Jazayeri SB, Alam MU et al (2021) An Indirect Comparison of Newer Minimally Invasive Treatments for Benign Prostatic Hyperplasia: a Network Meta-Analysis Model. J Endourol 35(4):409–416
doi: 10.1089/end.2020.0739
Roehrborn CG, Rukstalis DB, Barkin J et al (2015) Three year results of the prostatic urethral L.I.F.T. study. Can J Urol 22:7772–7782
pubmed: 26068624
McVary KT, Roehrborn CG (2018) Three-year outcomes of the prospective, randomized controlled rezūm system study: convective radiofrequency thermal therapy for treatment of lower urinary tract symptoms due to benign prostatic hyperplasia. Urology 111:1–9
doi: 10.1016/j.urology.2017.10.023
Darson MF, Alexander EE, Schiffman ZJ et al (2017) Procedural techniques and multicenter postmarket experience using minimally invasive convective radiofrequency thermal therapy with Rezūm system for treatment of lower urinary tract symptoms due to benign prostatic hyperplasia. Res Reports Urol 21(9):159–168
doi: 10.2147/RRU.S143679
Rukstalis D, Grier D, Stroup SP et al (2019) Prostatic Urethral Lift (PUL) for obstructive median lobes: 12 month results of the MedLift Study. Prostate Cancer Prostatic Dis 22(3):411–419
doi: 10.1038/s41391-018-0118-x