Open Access

ARTICLE

Rezum water vapor therapy for catheter- dependent urinary retention: a real-world Canadian experience

Dean S. Elterman¹, Naeem Bhojani², Christopher Vannabouathong¹, Bilal Chughtai³, Kevin C. Zorn²

1 Division of Urology, University Health Network, University of Toronto, Toronto, Ontario, Canada
2 University of Montreal Hospital Center, Université de Montréal, Montreal, Quebec, Canada
3 Department of Urology, Weill Cornell Medical College, New York Presbyterian, New York, New York, USA
Address correspondence to Dr. Dean S. Elterman, Room 317, 8th Floor, Main Pavilion, Toronto Western Hospital, 399 Bathurst Street, Toronto, ON M5T 2S8 Canada

Canadian Journal of Urology 2022, 29(2), 11075-11079.

Abstract

Introduction: This analysis reported outcomes of treating catheter-dependent urinary retention with Rezum water vapor therapy.
Materials and methods: A prospective registry was established at two high-volume Canadian centers. Patients had baseline medical and benign prostatic hyperplasia (BPH) history documented. The subgroup of patients with refractory, catheter-dependent urinary retention was analyzed. The primary outcome was the proportion of patients who were spontaneously voiding and catheter-free at 6 months.
Results: Sixteen patients (age: 68.7 years) with catheter-dependent urinary retention were treated with Rezum. Average prostate volume was 84.4 mL and 75% had median lobe. All patients had at least one recent failed trial without catheter (TWOC) and 87.5% were on BPH oral therapy. Mean number of vapor injections was 14.5. Visibility and bleeding during procedure were assessed using a 5-point scale, and were rated as 1.4 and 1.3, respectively. Anesthesia was either intravenous propofol sedation (n = 13) or self-administered methoxyflurane inhaler (n = 3). Mean catheter duration until first planned TWOC was 28.4 days. Three patients needed catheter replacement due to initial failed TWOC. One patient was lost to follow up, one patient did not return at 1 month, and one patient did not return at 3 months. At 1 month, 13/14 patients were spontaneously voiding and catheter-free. At 3 months, 14/14 patients were spontaneously voiding, and at 6 months, 15/15 patients were spontaneously voiding and catheter-free (1 patient was lost to follow up).
Conclusions: Rezum water vapor therapy can successfully treat catheter-dependent urinary retention after initial failed TWOC in an outpatient setting.

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