Real-world four-year functional and surgical outcomes of Rezum therapy in younger versus elderly men.


Journal

Prostate cancer and prostatic diseases
ISSN: 1476-5608
Titre abrégé: Prostate Cancer Prostatic Dis
Pays: England
ID NLM: 9815755

Informations de publication

Date de publication:
24 Aug 2023
Historique:
received: 19 04 2023
accepted: 17 07 2023
revised: 10 07 2023
medline: 25 8 2023
pubmed: 25 8 2023
entrez: 24 8 2023
Statut: aheadofprint

Résumé

Management of urinary symptoms in elderly patients with benign prostatic hyperplasia (BPH) is complex given challenges with medications and invasive surgeries. Rezum, a minimally invasive water vapor therapy, is an emerging alternative. We compare real-world Rezum outcomes between young and elderly patients over 4 years. We retrospectively analyzed a multiethnic population treated with Rezum at a single center between 2017-2019. Patients were stratified into young (<65 years) or elderly (≥65 years) cohorts. International Prostate Symptom Score (IPSS), Quality of Life (QoL), maximum urinary flow rate (Qmax), decisional regret scores, and adverse events (AEs) were assessed at baseline, 1-, 3-, 6-, 12-, and/or 48-months. Descriptive statistics were compared using t-tests, Chi-squared, or Mann-Whitney U tests. Changes in outcomes were assessed using Wilcoxon signed-rank tests, stratified by age. 256 patients - 146 (57%) young and 110 (43%) elderly - were included. The majority were Asian (33.2%) or non-Hispanic Black (28.9%). Significant improvements were observed in the combined cohort at 4-years in IPSS, QoL, and Qmax when compared to baseline (all p < 0.05). Between the age cohorts, there were no significant differences in IPSS, QoL, or Qmax at any follow-up. Within both cohorts, significant improvements in IPSS and QoL were found from baseline to all follow-ups. In the young cohort, Qmax was significantly improved from baseline to all follow-ups while in the elderly cohort, this was observed only at the 3-month follow-up. No significant differences in AEs or regret was found between cohorts. There was no significant difference in 4-year surgical retreatment rates between cohorts (elderly 4.0% vs young 4.4%, p = 0.86). There were no significant differences in IPSS, QoL, or AEs between elderly and younger men over 4 years following Rezum, suggesting comparable benefits and risks. Future research is warranted to clarify the impact of Rezum on Qmax in elderly men.

Sections du résumé

BACKGROUND BACKGROUND
Management of urinary symptoms in elderly patients with benign prostatic hyperplasia (BPH) is complex given challenges with medications and invasive surgeries. Rezum, a minimally invasive water vapor therapy, is an emerging alternative. We compare real-world Rezum outcomes between young and elderly patients over 4 years.
METHODS METHODS
We retrospectively analyzed a multiethnic population treated with Rezum at a single center between 2017-2019. Patients were stratified into young (<65 years) or elderly (≥65 years) cohorts. International Prostate Symptom Score (IPSS), Quality of Life (QoL), maximum urinary flow rate (Qmax), decisional regret scores, and adverse events (AEs) were assessed at baseline, 1-, 3-, 6-, 12-, and/or 48-months. Descriptive statistics were compared using t-tests, Chi-squared, or Mann-Whitney U tests. Changes in outcomes were assessed using Wilcoxon signed-rank tests, stratified by age.
RESULTS RESULTS
256 patients - 146 (57%) young and 110 (43%) elderly - were included. The majority were Asian (33.2%) or non-Hispanic Black (28.9%). Significant improvements were observed in the combined cohort at 4-years in IPSS, QoL, and Qmax when compared to baseline (all p < 0.05). Between the age cohorts, there were no significant differences in IPSS, QoL, or Qmax at any follow-up. Within both cohorts, significant improvements in IPSS and QoL were found from baseline to all follow-ups. In the young cohort, Qmax was significantly improved from baseline to all follow-ups while in the elderly cohort, this was observed only at the 3-month follow-up. No significant differences in AEs or regret was found between cohorts. There was no significant difference in 4-year surgical retreatment rates between cohorts (elderly 4.0% vs young 4.4%, p = 0.86).
CONCLUSIONS CONCLUSIONS
There were no significant differences in IPSS, QoL, or AEs between elderly and younger men over 4 years following Rezum, suggesting comparable benefits and risks. Future research is warranted to clarify the impact of Rezum on Qmax in elderly men.

Identifiants

pubmed: 37620427
doi: 10.1038/s41391-023-00703-0
pii: 10.1038/s41391-023-00703-0
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2023. The Author(s), under exclusive licence to Springer Nature Limited.

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Auteurs

Michael Zhu (M)

Albert Einstein College of Medicine, Bronx, NY, USA. Michael.Zhu@einsteinmed.edu.

Mustufa Babar (M)

Albert Einstein College of Medicine, Bronx, NY, USA.

Noah Hawks-Ladds (N)

Albert Einstein College of Medicine, Bronx, NY, USA.

Marc-Mina Tawfik (MM)

Albert Einstein College of Medicine, Bronx, NY, USA.

Justin Loloi (J)

Department of Urology, Montefiore Medical Center, Bronx, NY, USA.

Kevin Labagnara (K)

Albert Einstein College of Medicine, Bronx, NY, USA.

Rahman Sayed (R)

Albert Einstein College of Medicine, Bronx, NY, USA.

Kevin Tang (K)

Albert Einstein College of Medicine, Bronx, NY, USA.

Azizou Salami (A)

Albert Einstein College of Medicine, Bronx, NY, USA.

Sandeep Singh (S)

DSS Urology, Queens Village, New York, NY, USA.

Jaskirat Singh (J)

DSS Urology, Queens Village, New York, NY, USA.

Matthew Ines (M)

DSS Urology, Queens Village, New York, NY, USA.

Nazifa Iqbal (N)

DSS Urology, Queens Village, New York, NY, USA.

Michael Ciatto (M)

DSS Urology, Queens Village, New York, NY, USA.

Classifications MeSH