Comparing Patient-Reported Outcomes Following the Minimally Invasive Treatment of Benign Prostatic Hyperplasia (BPH)-Related Lower Urinary Tract Symptoms: Rezum Versus UroLift

Purpose The purpose of this study is to compare patient-reported outcomes of minimally invasive treatments for lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH), namely, transurethral water vapor therapy (Rezum) and prostatic urethral lift (UroLift), due to the lack of direct comparison in the existing literature. Methods A retrospective single-institution study was conducted comparing Rezum and UroLift procedures performed by three surgeons between January 2019 and June 2022. The difference in American Urological Association Symptom Scores (AUA SS) was the primary outcome measure. Associated quality of life (QOL) scores were additionally assessed. Patient-reported scores were completed prior to their procedure and at least one month after their procedure. Outcomes were compared between 80 Rezum-treated patients and 68 UroLift-treated patients utilizing Mann-Whitney U tests and Fisher's exact tests. Results Rezum-treated patients were younger on average at 67.55 years compared to 71.79 years in UroLift-treated patients (p=0.0049). Prior to treatment, the mean initial AUA SS was 22.46 for Rezum-treated patients and 19.96 for UroLift-treated patients (p=0.0164). Following treatment, the mean AUA SS improved to 9.83 for Rezum-treated patients and 13.37 for UroLift-treated patients (p=0.0026). Overall, Rezum-treated patients reported a 58.29% improvement in the mean AUA SS, while UroLift-treated patients reported a 44.53% improvement in the mean AUA SS (p=0.002). The mean follow-up QOL was 1.89 for Rezum-treated patients and 2.72 for UroLift-treated patients (p=0.0079). Conclusion Both Rezum and UroLift demonstrate efficacy in the treatment of BPH-related LUTS. Patients who underwent Rezum reported worse initial urinary symptoms and better post-procedural urinary symptoms and quality of life compared to those who underwent UroLift.