Water vapour thermal therapy, a minimally invasive treatment, significantly alleviates moderate to severe lower urinary tract symptoms secondary to benign prostatic hyperplasia, a study has shown. It also provides flow rate improvements through 5 years, with low surgical retreatment rates and without affecting sexual function.
In total, 197 patients aged >50 years with International Prostate Symptom Score ≥13, maximum flow rate ≤15 ml/second, and prostate volume 30 to 80 cc were randomized and followed for 5 years. Fifty-three of 61 participants in the control group requalified and after 3 months received treatment as part of the crossover group; they were also followed for 5 years.
The total number of vapour treatments to each lobe of the prostate was determined by length of prostatic urethra and included middle lobe treatment following physician discretion.
At <3 months post-thermal therapy, a significant reduction in lower urinary tract symptoms occurred and persisted through 5 years in the treatment group: International Prostate Symptom Score decreased by 48 percent, quality of life increased by 45 percent, maximum flow rate improved by 44 percent, and Benign Prostatic Hyperplasia Impact Index decreased by 48 percent.
Surgical retreatment rate stood at 4.4 percent, with no reports of device- or procedure-related sexual dysfunction or sustained de novo erectile dysfunction. Of note, similar results were noted within the crossover group and remained durable through 5 years.
“[Water vapour thermal therapy] is a versatile therapy, providing successful treatment to obstructive lateral and middle lobes,” the researchers said.