TRANSURETHRAL THERMAL WATER-VAPOR TREATMENT WITH THE REZUM DEVICE IN PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA

Background. Benign prostatic hyperplasia (BPH) is a common condition among men that is often accompanied by symptoms of lower urinary tract dysfunction, such as urinary impairment. These symptoms significantly reduce the quality of life and frequently require various forms of treatment. Despite existing treatment methods, including drug therapy and surgical intervention, a high risk of adverse effects and complications, including sexual dysfunction, remains high. Moreover, the recently emerged minimally invasive ablative treatment methods have their limitations, creating a demand for effective new solutions. Main Content. Thermal treatment using water vapor with the Rezum device has demonstrated its efficacy, with low rates of complications and recurrences, as well as the ability to preserve sexual function. This work is based on the analysis of global literature and expert opinions that have attempted to develop recommendations for the application of thermal therapy, taking into account clinical, laboratory, and instrumental data. The review analyzes various aspects of performing the Rezum procedure in BPH patients before, during, and after the intervention, incorporating the insights of competent experts in the field of urology. The analysis of sources showed that thermal vapor therapy may be an acceptable option for patients with moderate to severe symptoms, without age restrictions, with a maximal urinary flow rate (Qmax) of less than 15 ml/s and a prostate volume greater than 30 cm3, but not necessarily less than 80 cm3. A low recurrence rate and minimal impact on erectile and ejaculatory function were also demonstrated in patients who underwent treatment with the Rezum device. Conclusions. The Rezum method is considered a safe surgical treatment option for BPH patients and can serve as a first-line therapy for certain patient categories. However, further research is needed on various issues regarding the application of the Rezum method, including the timing of postoperative bladder drainage with a urethral catheter, types of anesthesia, the need for and timing of antibiotic prophylaxis, and the specifics of postoperative monitoring and tracking long-term outcomes.