PD21-04 TREATMENT OF LOWER URINARY TRACT SYMPTOMS DUE TO BENIGN PROSTATIC HYPERPLASIA WITH CONVECTIVE WATER VAPOR ENERGY ABLATION: PRESERVED ERECTILE AND EJACULATORY FUNCTION

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology I1 Apr 2016PD21-04 TREATMENT OF LOWER URINARY TRACT SYMPTOMS DUE TO BENIGN PROSTATIC HYPERPLASIA WITH CONVECTIVE WATER VAPOR ENERGY ABLATION: PRESERVED ERECTILE AND EJACULATORY FUNCTION Kevin McVary, Steven Gange, Marc Gittelman, Kenneth Goldberg, Kalpesh Patel, Neal Shore, Richard Levin, Michael Rousseau, J. Randolf Beahrs, Jed Kaminetsky, Barrett Cowan, Christopher Cantrill, Lance Mynderse, James Ulchaker, Thayne Larson, Christopher Dixon, and Claus Roehrborn Kevin McVaryKevin McVary More articles by this author , Steven GangeSteven Gange More articles by this author , Marc GittelmanMarc Gittelman More articles by this author , Kenneth GoldbergKenneth Goldberg More articles by this author , Kalpesh PatelKalpesh Patel More articles by this author , Neal ShoreNeal Shore More articles by this author , Richard LevinRichard Levin More articles by this author , Michael RousseauMichael Rousseau More articles by this author , J. Randolf BeahrsJ. Randolf Beahrs More articles by this author , Jed KaminetskyJed Kaminetsky More articles by this author , Barrett CowanBarrett Cowan More articles by this author , Christopher CantrillChristopher Cantrill More articles by this author , Lance MynderseLance Mynderse More articles by this author , James UlchakerJames Ulchaker More articles by this author , Thayne LarsonThayne Larson More articles by this author , Christopher DixonChristopher Dixon More articles by this author , and Claus RoehrbornClaus Roehrborn More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1471AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To report the prospective analysis of sexual function evaluated in a randomized controlled study of transurethral prostate convective water vapor thermal energy (Rezum System) to treat lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). RF-generated wet thermal energy (water vapor), dispersed by convection can be targeted to defined prostate zones including the median lobe to achieve rapid tissue ablation. METHODS Men ≥50 years old with IPSS ≥ 13, Qmax ≤15 ml/s, prostates of 30-80 cc were stratified by International Prostate Symptom Score (IPSS) severity and randomized 2:1 to thermal therapy with the Rezum System and control. The control procedure was rigid cystoscopy with mimicked active treatment sounds. A wash-out period was required for all daily use of drugs for LUTS and/or erectile dysfunction (ED). The blinded group was compared at 3 months and treatment group evaluated over 1 year for LUTS with IPSS, flow rate (Qmax) and sexual function with the International Index of Erectile Function (IIEF-EF) and the Male Sexual Health Questionnaire for Ejaculatory Dysfunction (MSHQ-EjD). RESULTS 197 men were randomized. LUTS improved 11 points in the active group (N=136) at 3 months vs. 4.3 points for control group (N=61), p<0.0001. In men with severe LUTS (IPSS >19), 85% achieved ≥ 30% reduction in symptoms. Qmax increased 68% (6.2 ml/s) at 3 months vs. no change in controls (p <0.0001). These improvements were sustained in 96% of treated subjects who completed their 1-year follow-up (p<0.0001). At study entry, 52% of treatment subjects had a history of erectile dysfunction (ED) and 26% had decreased-stoppage ejaculation. Only sexually active men (91/136) 67% were included in the sexual function analyses. In these, the IIEF-EF baseline mean was 17.2 (30 max score) and the MSHQ-EjD mean was 7.8 (15 max). There were no clinically meaningful negative changes in scores over 12 months. Modest decreases in ejaculatory volume occurred in 6 men (4.4%), anejaculation in 4 men (2.9%). No de novo ED was reported. CONCLUSIONS Conservation of sexual function is a fundamental QOL issue for men contemplating a nonsurgical treatment options for LUTS/ BPH. Convective water vapor thermal energy therapy is a minimally invasive treatment that provides rapid and durable LUTS improvements and no clinically significant changes in erectile and ejaculatory function. The thermal energy treatment was developed for in-office use and shown to be applicable to treatment of all prostate zones including median lobes. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e457-e458 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Kevin McVary More articles by this author Steven Gange More articles by this author Marc Gittelman More articles by this author Kenneth Goldberg More articles by this author Kalpesh Patel More articles by this author Neal Shore More articles by this author Richard Levin More articles by this author Michael Rousseau More articles by this author J. Randolf Beahrs More articles by this author Jed Kaminetsky More articles by this author Barrett Cowan More articles by this author Christopher Cantrill More articles by this author Lance Mynderse More articles by this author James Ulchaker More articles by this author Thayne Larson More articles by this author Christopher Dixon More articles by this author Claus Roehrborn More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...