AB008. SOH26AB_0376. A novel transurethral steam ablation (Rezum) therapy for benign prostatic hyperplasia: a step-by-step video technique

Abstract: Lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) are one of the most common morbidities in elderly men, especially in ageing societies. Minimally invasive surgical treatments (MISTs) for BPH have gained increasing interest in recent years. The Rezum system is a novel MIST that uses water vapour-based convective thermal therapy to ablate prostatic tissue. We describe details of the Rezum technique in a video. An 80-year-old gentleman with bothersome LUTS refractory to medical treatment, magnetic resonance imaging (MRI) prostate suggesting BPH of about 60 cc, underwent Rezum treatment under general anaesthesia. Steam ablation was performed at a total of seven locations covering the right and left lateral lobes of the prostate between the bladder neck and the verumontanum at 3 and 9 o’clock orientations. A size 16-F silicon catheter was inserted at the end. Our video demonstrates details of the step-by-step technique. Total theatre utilisation time was 35 minutes, but actual procedure time was 8 minutes. He was admitted overnight due to a social reason. A trial without a catheter after 2 weeks demonstrated subjective and objective improvement in LUTS. His International Prostate Symptom Score (IPSS) reduced from 18 to 8, and the maximum urine flow rate improved from 12 to 18 mL/s. There were no complications. Rezum steam ablation for BPH is an easy, quick, safe, and effective novel technique that has the potential to reduce waiting lists for BPH treatment.

Keywords: Rezum; steam ablation; prostate; benign prostatic hyperplasia (BPH); minimally invasive surgical treatment (MIST)