Water Vapor Thermal Therapy in Men With Prostate Volume ≥80 cm3: A Systematic Review and Meta-Analysis.

To determine the safety and effectiveness of water vapor thermal therapy (Rezum) in men with large prostate volumes of at least 80 cm3. We performed systematic searches for studies of Rezum therapy in men with prostate volume of at least 80 cm3. Meta-analysis outcomes included the International Prostate Symptom Score (IPSS), IPSS Quality of Life (IPSS-QOL), Qmax, postvoid residual, International Index of Erectile Function-Erectile Function (IIEF-EF), and serious (Clavien-Dindo grade III-V) complications, surgical retreatments. Outcomes were analyzed using a random effects meta-analysis model. The review included 15 studies (11 retrospective) of 471 men with prostate volume at least 80 cm3 treated with Rezum therapy and followed for a median of 6 months (range: 3-17 months). Rezum therapy resulted in statistically significant improvements in IPSS (mean change: − 11.0; 95% CI: − 12.2, − 9.7; P <.001), IPSS-QOL (mean change: − 2.9; 95% CI: − 3.5, − 2.4; P <.001), Qmax (mean change: 6.5 mL/s; 95% CI: 4.8, 8.2 mL/s; P <.001), and postvoid residual (mean change: − 101 mL; 95% CI: − 145, − 57; P <.001). No change in IIEF-EF was observed (mean change: 0.3; 95% CI: − 1.1, 1.6; P =.71). Serious complications occurred in <0.1% (95% CI: 0.0%, 0.4%) and surgical retreatment in 1.2% (95% CI: 0.0%, 3.5%) of patients. Rezum therapy provides a statistically significant and clinically important short-term improvement in lower urinary tract symptoms with low complication rates in men with prostate volume of at least 80 cm3. Long-term outcomes with Rezum therapy in large prostates remain unclear. [ABSTRACT FROM AUTHOR]