Italian live Delphi consensus on indications, peri-procedural management, technique, and learning curve of convective water vapor thermal therapy (Rezum™) in men with LUTS/BPH

INTRODUCTION: Convective water vapor thermal therapy (WVTT, Rezum™) is an established minimally invasive surgical technique for men with LUTS secondary to benign prostatic hyperplasia (BPH). Despite increasing adoption, patient selection, peri-procedural management, technical execution, and training remain heterogeneous. We conducted a live modified Delphi consensus to define pragmatic, expert-driven recommendations for WVTT practice in Italy. MATERIALS AND METHODS: A 10-member steering committee screened the literature and drafted candidate statements across eight predefined domains. A live modified Delphi process was conducted with 22 Italian urologists. Panelists voted using a four-level response scale; justifications were required for any response other than full agreement. Statements below the predefined consensus threshold were discussed, reformulated when appropriate, and re-voted. Consensus was defined a priori as ⩾75% full agreement. RESULTS: (77.3% → 100%) and supervision during the initial learning curve (31.8% → 61.9% → 90.5%). CONCLUSIONS: This live Delphi consensus provides practice-oriented guidance for WVTT and defines areas of strong expert agreement alongside persistent evidence gaps. The findings support standardized adoption of WVTT within defined indications while prioritizing future research on peri-procedural protocols and follow-up pathways.

Authors

Institutions

Publication Details

Journal
Urologia Journal
Published
2026-04-16
DOI
https://doi.org/10.1177/03915603261440260
Primary Topic
Thermal Regulation in Medicine
Type
article
Field-Weighted Citation Impact
0.00
Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

Italian live Delphi consensus on indications, peri-procedural management, technique, and learning curve of convective water vapor thermal therapy (Rezum™) in men with LUTS/BPH

S. Fracalanza, P. Tuzzolo, Emanuele Rubilotta, Francesco Greco et al.
Urologia Journal
Thermal Regulation in Medicine
article

Italian live Delphi consensus on indications, peri-procedural management, technique, and learning curve of convective water vapor thermal therapy (Rezum™) in men with LUTS/BPH

S. Fracalanza, P. Tuzzolo, Emanuele Rubilotta, Francesco Greco, Federico Pierella, Alberto Olivero, Claudio Lamon, Luca Cindolo, Petros Sountoulides, Raffaele Balsamo, Gennaro Annunziata, Roberto Castellucci, Stefano Cavalleri, Roberto Renzetti, Evangelista Martinelli, Francesco Varvello, Giulio Bevilacqua, G. Abatangelo, Romagnoli Daniele, Francesco Visalli, Francesco Pinto, Stefano De Luca, Silvia Secco, Carlo Marenghi, Sebastiano Condorelli, Eros Scarciglia
article en

Abstract

INTRODUCTION: Convective water vapor thermal therapy (WVTT, Rezum™) is an established minimally invasive surgical technique for men with LUTS secondary to benign prostatic hyperplasia (BPH). Despite increasing adoption, patient selection, peri-procedural management, technical execution, and training remain heterogeneous. We conducted a live modified Delphi consensus to define pragmatic, expert-driven recommendations for WVTT practice in Italy. MATERIALS AND METHODS: A 10-member steering committee screened the literature and drafted candidate statements across eight predefined domains. A live modified Delphi process was conducted with 22 Italian urologists. Panelists voted using a four-level response scale; justifications were required for any response other than full agreement. Statements below the predefined consensus threshold were discussed, reformulated when appropriate, and re-voted. Consensus was defined a priori as ⩾75% full agreement. RESULTS: (77.3% → 100%) and supervision during the initial learning curve (31.8% → 61.9% → 90.5%). CONCLUSIONS: This live Delphi consensus provides practice-oriented guidance for WVTT and defines areas of strong expert agreement alongside persistent evidence gaps. The findings support standardized adoption of WVTT within defined indications while prioritizing future research on peri-procedural protocols and follow-up pathways.

Urologia Journal
University of Bergamo (IT), University of Modena and Reggio Emilia (IT), Aristotle University of Thessaloniki (GR), Policlinico Umberto I (IT), Agostino Gemelli University Polyclinic (IT), Aurelia Hospital (IT), Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda (IT), Azienda Ospedaliera Universitaria Integrata Verona (IT), AULSS 2 Marca Trevigiana (IT), Ospedale Sacro Cuore Don Calabria (IT), Ospedale di Santo Spirito (IT), Presidio Ospedaliero (IT), Policlinico Abano Terme (IT), Ospedale Monaldi (IT), Ca' Foncello Hospital (IT), Azienda Ospedale - Università Padova (IT), Ospedale San Bortolo (IT), Ospedale San Luigi Gonzaga (IT), Ospedale Civile di Venezia (IT), Ospedale Santa Corona (IT), Ospedale San Pietro Fatebenefratelli (IT)
Clean water and sanitation
Openalex Percentile: Top 18%
Thermal Regulation in Medicine
DOISourceOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.