Prostate steam treatment


Prostate steam treatment, also called water vapor thermal therapy, is a minimally invasive surgical procedure for men with lower urinary tract symptoms resulting from prostate enlargement. It uses injections of steam to remove obstructive prostate tissue from the inside of the organ without injuring the prostatic part of the urinary tube.
Although it is a relatively new technique, one trial showed positive outcomes in a four-year follow-up.

Medical uses

As of 2019, trials including one randomized control trial show encouraging results for benign prostatic hypertrophy. A 2018 review found four trials that showed positive outcomes at 1 to 2 years of follow up. It however has not been compared to transurethral resection of the prostate as of 2018.
Water vapor thermal therapy was looked at in larger volume prostates and in those with middle lobes protruding into the bladder and appears to work. The procedure has shown to not affect sexual function across a few studies.

Procedure

It is an outpatient or office-based procedure. The equipment consists of a vapor generator and a transurethral delivery device. The latter is similar to a cystoscope with an optical system with a 90° extending retractable 10.25 mm long injection needle. From this needle water vapor is circumferentially delivered via 12 holes at the needle’s tip. Depending on the size of the prostate an adequate number of injections is delivered to the two side lobes and to the middle lobe of the prostate. Each injection lasts 9 seconds and the space between adjacent injections is about 10 mm.
Upon condensation of the vapor upon cell membranes, cell death and necrosis occur immediately. Over a period of about three months the dead cells are removed by the body, thus shrinking the prostate and relieving BPH symptoms.

History

The Rezum system was introduced by NxThera. It was approved by the United States Food and Drug Administration in 2015 and the National Institute for Health and Care Excellence of the UK in 2018. As of August 2018 the system was in use in 5 National Health Service hospitals in England, and due to be implemented in a further 15.