Risk Factors for Persistent Lower Urinary Tract Symptoms 1 Month Following Convective Water Vapor Thermal Therapy (CWVTT-Rezum)

ABSTRACT

Objectives

To investigate the incidence and risk factors of persistent lower urinary tract symptoms (LUTS) one month and later following convective water vapor thermal therapy (CWVTT) in men with LUTS secondary to benign prostatic hyperplasia (BPH).

Methods

Patients who underwent CWVTT from 11/2018- 5/2021 at a single institution were eligible for inclusion and retrospectively identified. Pertinent patient, operative, and outcomes data were extracted. The primary outcome was clinically significant LUTS improvement at 4 weeks following CWVTT. Persistent LUTS was defined as failure to reach a minimally important clinical difference (MCID) of 25% reduction on International Prostate Symptom Score (IPSS) at 4 weeks.

Results

109 patients qualified. 50% of patients experienced persistent LUTS at one month. 82% of men ultimately reached the MCID. For each additional month following CWVTT, the odds of achieving clinically significant LUTS improved by 9% (OR=0.91, p=.003). Bladder outlet obstruction index (BOOI) and prior surgical BPH therapy were associated with persistent LUTS on multivariate logistic regression. Every 10-unit increase in BOOI noted at baseline was associated with a 15% increased likelihood of achieving MCID in LUTS at 4 weeks following CWVTT (OR=0.85, p=.01). Patients receiving prior surgical BPH therapy were 3.5 times more likely to experience persistent LUTS at one month (OR=3.47, p=.01).

Conclusions

50% of men experienced persistent LUTS one month following CWVTT. However, LUTS improved with time and the majority of men ultimately achieved clinically significant LUTS improvement. A lower baseline BOOI and prior BPH procedures are risk factors for persistent LUTS following CWVTT.