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. 2025 Nov 30;14(11):3546-3553.
doi: 10.21037/tau-2025-568. Epub 2025 Nov 25.

Do patients Rezum medications?-a real-world analysis of medical retreatment after water vapor thermal therapy

Vi Nguyen  1   2 , Elizabeth Tran  2 , Clara Cerrato  3 , Jamie L Finegan  2 , Michelle C Leach  2   4 , Seth K Bechis  2
Affiliations

Do patients Rezum medications?-a real-world analysis of medical retreatment after water vapor thermal therapy

Vi Nguyen et al. Transl Androl Urol. .

Abstract

Background: Little is known regarding medical retreatment rates after water vapor thermal therapy (WVTT; Rezum, Boston Scientific, Marlborough, MA, USA) for benign prostatic hyperplasia (BPH). We sought to identify incidence and predictors of medical retreatment for symptomatic recurrence among this population.

Methods: We performed a single institution retrospective review of patients who underwent WVTT by a single surgeon from July 2018 to January 2024. We excluded patients with prostate volume >80 cc. Primary outcome was medical retreatment, defined as initiation or resumption of any BPH medication following WVTT.

Results: We identified 155 patients with mean age 67.4±10.3 years and prostate volume 46.4±13.6 cc. Forty-eight (31%) patients underwent medical retreatment within mean follow up of 19.5 months. Mean time to retreatment was 9.8 months. Alpha blockers were the most commonly restarted medication (40.5%), followed by daily tadalafil (25.5%) and 5-alpha reductase inhibitors (10.6%); 23.4% of patients restarted multiple medications. Preoperative use of alpha blockers (95.8% vs. 84.1%; P=0.04), 5-alpha reductase inhibitors (39.6% vs. 23.4%; P=0.04) and daily tadalafil (35.4% vs. 15.0%; P=0.004) significantly predicted medical retreatment. At 3 months, International Prostate Symptom Scores (IPSS) total (15.5±7.9 vs. 9.8±6.1, P=0.002) and quality of life (QoL) (3.2±1.6 vs. 2.4±1.5, P=0.05) were significantly higher in the medical retreatment group. Surgical retreatment within 3 years occurred in 9.7% of the cohort, with nonsignificant higher rates in the medical retreatment group (12.5% vs. 8.4%, P=0.43).

Conclusions: Nearly one-third of patients undergo medical retreatment after WVTT, often within the first year. Early symptom trajectory, preoperative medication use, and close follow-up may help identify patients at risk and improve long-term outcomes.

Keywords: Benign prostatic hyperplasia (BPH); Rezum; medical retreatment; minimally invasive surgical therapy (MIST); water vapor thermal therapy (WVTT).

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tau.amegroups.com/article/view/10.21037/tau-2025-568/coif). S.K.B. reports receiving consulting fees from Boston Scientific, Dornier, Ambu Medical, Calyxo, BD and payment for lectures from Karl Storz. The other authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Summary of study findings. WVTT, water vapor thermal therapy.
Figure 2
Figure 2
Proportions of medications restarted. BPH, benign prostatic hyperplasia.
See this image and copyright information in PMC

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