Water vapor thermal therapy: Technical variations among spanish hospitals and efficacy at 2-year follow-up

• Published in: Actas urológicas españolas (English ed.) 2023-12, Vol.47 (10), p.668-674
• Main Authors: Schwartzmann, I., García Barreras, S., D’Anna, M., Parejo, V., Torneo Ruiz, I., Tagalos Muñoz, A.C., Bravo-Balado, A., Diana, P., Peri, L., Domínguez Esteban, M., Fernández Guzmán, E.
• Format: Article
• Language: English
• Subjects: Benign prostatic hyperplasia; BPH; Follow-Up Studies; HBP; Hiperplasia benigna de próstata; Hospitals; Humans; Male; Minimally invasive surgical treatment; Postoperative Complications - epidemiology; Prostatic Hyperplasia - complications; Prostatic Hyperplasia - surgery; Retrospective Studies; Rezūm; Steam; Terapia térmica con vapor de agua; Tratamiento quirúrgico mínimamente invasivo; Treatment Outcome; Water vapor thermal therapy
• ISSN: 2173-5786; 2173-5786
• DOI: 10.1016/j.acuroe.2023.07.001

The aim of this work is to evaluate the initial experience with water vapor thermal therapy (WVTT) for benign prostatic hyperplasia (BPH) in Spanish university hospitals, as well as to describe the differences in technique and follow-up between centers. This retrospective observational multicenter study collected baseline characteristics, surgical, postoperative and follow-up data at 1, 3, 6, 12 and 24 months, including validated questionnaires, flowmetric variations, complications, and the need for pharmacological or surgical treatment following the procedure. Possible triggers for postoperative acute urinary retention (AUR) were also analyzed. A total of 105 patients were included. No differences were observed between the groups with and without AUR with respect to catheterization time (5 and 4.3 days respectively, P=.178), or prostate volume (47.9g and 41.4g respectively, P=.147). The mean improvement at 3, 6, 12 and 24 months in terms of peak flow was 5.3, 5.2, 4.2 and 3.8ml/s, respectively. As for ejaculation, an improvement was observed after 3 months of follow-up and was maintained over time. Minimally invasive treatment for BPH with WVTT shows good functional outcomes at 24 months follow-up, without significant impairment of sexual function and a low incidence of complications. There are minor inter-hospital variations, mainly in the immediate postoperative period. El objetivo de este trabajo es conocer experiencia inicial con la terapia térmico con vapor de agua (TTVA) para hiperplasia benigna de próstata en los hospitales universitarios españoles, así como describir las diferencias en cuanto a técnica y a seguimiento observadas entre los centros. Este estudio multicéntrico observacional retrospectivo recogió características basales, datos quirúrgicos, postoperatorios y seguimiento a los 1, 3, 6, 12 y 24 meses, incluyendo cuestionarios validados, variaciones flujométricas, complicaciones y la necesidad de tratamiento farmacológico u quirúrgico tras el procedimiento. También se analizaron los posibles desencadenantes de retención aguda de orina (RAO) en el postoperatorio. Se incluyeron un total de 105 pacientes. No se observaron diferencias entre los grupos con y sin RAO con respecto a tiempo de sondaje (5 y 4.3 días respectivamente, P=.178), ni volumen prostático (47.9g y 41.4g respectivamente, P=.147). La mejoría media a los 3, 6, 12 y 24 meses en cuanto de flujo máximo fue de 5.3, 5.2, 4.2 y 3.8ml/s, respectivamente. En cuanto a la eyaculación,