Rezūme: The Office-based Procedure in Benign Prostate Hyperplasia

Usama Nihad Rifat

Edtorial

Benign Prostatic Hyperplasia (BPH) presents when the enlarged prostate squeezes the prostatic urethra, causing bladder outlet obstruction [1]. Minimally invasive surgical treatments help in symptom improvement. (Rezūme System, NxThera Inc., Maple Grove, MN, USA) is an example. It offers effective treatment of BPH, reduces sexual side effects, anesthetic requirements, and long hospitalizations. Rezūme uses heated steam injections within the prostatic transition zone to thermally vaporize hyperplastic tissue. Studies showed the median operative time was 10.5 min. All patients were discharged few hours after surgery with indwelling urinary catheter that was removed after a median of 7 days. [2] It was also found that Rezūme is effective in patients with glands >80 cc [3]. Rezūm assures a short recovery time and return to normal activity and preserves sexual and ejaculatory functions [4]. Compared to aqua ablation they both use water, but in different ways. Rezūme is office-based and aqua ablation is operatingroom-based. One is minimally invasive, and the other is more a surgical management of BPH [5,6].

Exime® catheter (Rocamed; Munich, Germany). This catheter allows the patient to live a normal life without using any urine bag or catheter stopper. Indeed, Exime^® (Rocamed) is a temporary prostatic stent which is inserted in the prostatic urethra, proximal to the sphincter, to enable the patient to urinate independently. This catheter was used instead of the standard catheter and patients started to urinate in a normal way immediately after the water vapor treatment. The treatment was performed as an outpatient procedure. Cases with a prostate volume of 186 cc. were managed successfully [7,8]. These initial data for the Rezūm System seem very promising. Rezūm has demonstrated significant improvements in American Urological Association symptom score, flow rate, and prostate volume reduction. When compared indirectly with medical therapy, Rezūm was superior to monotherapy. The Rezūm System has the advantage of being performed in an office setting under local anesthesia in prostates of various shapes and sizes. The Rezūm System also allows the treatment of median lobes while preserving erectile and ejaculatory function [9,10].